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探究本科阶段关于谵妄的教学未能确保达到金标准实践的原因——英国全国性调查结果

Towards an understanding of why undergraduate teaching about delirium does not guarantee gold-standard practice--results from a UK national survey.

作者信息

Fisher James Michael, Gordon Adam Lee, MacLullich Alasdair M J, Tullo Ellen, Davis Daniel H J, Blundell Adrian, Field Robert H, Teodorczuk Andrew

机构信息

Department of Medicine, Northumbria Healthcare NHS Foundation Trust, Wansbeck General Hospital, Woodhorn Lane, Ashington, Northumberland, UK.

Division of Rehabilitation and Ageing, University of Nottingham, Medical School, Queens Medical Centre, Nottingham, UK.

出版信息

Age Ageing. 2015 Jan;44(1):166-70. doi: 10.1093/ageing/afu154. Epub 2014 Oct 16.

Abstract

BACKGROUND

delirium is common and serious, yet frequently missed by medical staff. It is known that delirium is widely taught and examined in UK medical schools; however, what is taught, and how such teaching is delivered, remains unknown. The primary aim of this study was to determine the content of UK undergraduate medical education about delirium and establish how it is delivered. A secondary aim was to highlight and share examples of gold-standard teaching on delirium.

METHODS

all UK undergraduate medical schools were invited to complete a survey. Schools were asked to describe how delirium was taught and to provide delirium-related learning outcomes. Learning outcomes were mapped to the three overarching themes outlined in Tomorrow's Doctors (knowledge, skills and attitudes).

RESULTS

24/31 schools (77%) provided responses. In line with previous work, delirium was widely taught and examined. 18/24 schools reported at least one learning outcome that mapped to the knowledge domain, 19/24 for the skills domain and 2/24 for the attitudes domain. 4/24 evaluated the impact of sessions and 3/24 involved patients and the public in teaching. 13/24 schools were confident that exposure to delirium was guaranteed. Innovative teaching methods were reported by a number of schools; weblinks to examples are provided.

DISCUSSION

there was widespread failure to address attitudes on delirium within teaching, to evaluate the impact of sessions, to involve patients and the public in teaching and to guarantee exposure to delirium. Future teaching interventions should be directed at attitudinal outcomes, using a synthesis of clinical experience with multidisciplinary interaction and supportive technologies.

摘要

背景

谵妄很常见且严重,但医护人员常常漏诊。众所周知,英国医学院校广泛教授并考查谵妄相关内容;然而,具体教授了哪些内容以及如何授课仍不为人知。本研究的主要目的是确定英国本科医学教育中关于谵妄的内容,并确定其授课方式。次要目的是突出并分享谵妄金标准教学的实例。

方法

邀请了英国所有本科医学院校完成一项调查。要求各院校描述谵妄的授课方式,并提供与谵妄相关的学习成果。学习成果被映射到《明日医生》中概述的三个总体主题(知识、技能和态度)。

结果

31所院校中有24所(77%)做出了回应。与之前的研究一致,谵妄被广泛教授和考查。24所院校中有18所报告了至少一项映射到知识领域的学习成果,19所映射到技能领域,2所映射到态度领域。24所院校中有4所评估了课程的影响,24所中有3所让患者和公众参与教学。24所院校中有13所确信学生能接触到谵妄相关内容。一些院校报告了创新的教学方法;提供了相关示例的网络链接。

讨论

在教学中普遍未能涉及对谵妄的态度、评估课程的影响、让患者和公众参与教学以及确保学生接触到谵妄相关内容。未来的教学干预应针对态度方面的成果,综合运用临床经验、多学科互动和支持技术。

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