农村和城市医师助理的皮肤科诊断情况。

Dermatology diagnoses among rural and urban physician assistants.

作者信息

Brown Bryon, Bushardt Reamer, Harmon Kevin, Nguyen Shaun A

机构信息

Bryon Brown was a student in the PA program at the Medical University of South Carolina (MUSC), Charleston, when this article was written and is the principal investigator and primary author. Co-investigator Reamer Bushardt is Associate Professor and Director, and co-investigator Kevin Harmon is Assistant Professor, both in the Division of Physician Assistant Studies, MUSC. Research mentor Shaun Nguyen is a physician, biostatistician, and Assistant Professor, Department of Otolaryngology, Head and Neck Surgery, MUSC. The authors have indicated no relationships to disclose relating to the content of this article.

出版信息

JAAPA. 2009 Dec;22(12):32-5, 39. doi: 10.1097/01720610-200912000-00008.

DOI:10.1097/01720610-200912000-00008

PMID:24887466

Abstract

OBJECTIVES

Dermatology is not heavily covered in the curricula of physician assistant (PA) programs or on the certification examination, even though patient visits to PAs for skin complaints are very common. If significant on-the-job training is thus required for dermatology care, then practice setting differences likely impact the quality of that informal training. This study sought to identify differences in the ability of rural and urban PAs to diagnose skin disorders.

METHODS

An Internet-based survey of rural and urban primary care PAs (n = 295) was conducted. The survey collected demographic information and provided case scenarios with questions related to diagnosis of a skin disease or complication.

RESULTS

Average quiz score was higher for rural PAs than for urban PAs (61.6% versus 55.4%, P = .024). Rural PAs more commonly treated the majority of their patients seen for skin complaints. Rural PAs reported a greater comfort level in diagnosing and treating skin disease than did urban PAs (91% versus 80%, P < .05). Both groups referred a comparable percentage of patients to skin specialists. Regression analysis identified several factors that accounted for the ability to predict success scores for both the rural (P < .05) and urban (P < .05) groups.

CONCLUSIONS

The stronger overall ability of rural PAs to diagnose a variety of skin diseases is likely impacted by the higher number of dermatologic cases they see. PA educators should re-evaluate the curricula devoted to skin conditions and consider elective opportunities for students with an interest in a dermatology career.

摘要

目的

尽管患者因皮肤问题就诊于医师助理（PA）的情况非常普遍，但医师助理项目的课程设置以及认证考试中对皮肤科的覆盖并不多。因此，如果皮肤科护理需要大量在职培训，那么不同的执业环境可能会影响这种非正式培训的质量。本研究旨在确定农村和城市医师助理诊断皮肤疾病能力的差异。

方法

对农村和城市基层医疗医师助理（n = 295）进行了一项基于互联网的调查。该调查收集了人口统计学信息，并提供了与皮肤疾病或并发症诊断相关问题的病例场景。

结果

农村医师助理的平均测验得分高于城市医师助理（61.6% 对 55.4%，P = 0.024）。农村医师助理更常诊治大多数因皮肤问题前来就诊的患者。农村医师助理报告在诊断和治疗皮肤疾病方面比城市医师助理更有信心（91% 对 80%，P < 0.05）。两组转诊至皮肤科专家的患者比例相当。回归分析确定了几个因素，这些因素可用于预测农村组（P < 0.05）和城市组（P < 0.05）的成功得分能力。