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门诊诊所中的督导式近伴临床教学:一项关于家庭医学住院医师观点的探索性研究

Supervised near-peer clinical teaching in the ambulatory clinic: an exploratory study of family medicine residents' perspectives.

作者信息

Ince-Cushman Daniel, Rudkin Teresa, Rosenberg Ellen

机构信息

Department of Family Medicine, McGill University, 5700, chemin de la Côte-des-Neiges, H3T 2A8, Montréal, QC, Canada,

出版信息

Perspect Med Educ. 2015 Feb;4(1):8-13. doi: 10.1007/s40037-015-0158-z.

Abstract

Near-peer teaching is used extensively in hospital-based rotations but its use in ambulatory care is less well studied. The objective of this study was to verify the benefits of near-peer teaching found in other contexts and to explore the benefits and challenges of near-peer clinical supervision unique to primary care. A qualitative descriptive design using semi-structured interviews was chosen to accomplish this. A faculty preceptor supervised senior family medicine residents as they supervised a junior resident. We then elicited residents' perceptions of the experience. The study took place at a family medicine teaching unit in Canada. Six first-year and three second-year family medicine residents participated. Both junior and senior residents agreed that near-peer clinical supervision should be an option during family medicine residency training. The senior resident was perceived to benefit the most. Near-peer teaching was found to promote self-reflection and confidence in the supervising resident. Residents felt that observation by a faculty preceptor was required. In conclusion, the benefits of near-peer teaching previously described in hospital settings can be extended to ambulatory care training programmes. However, the perceived need for direct observation in a primary care context may make it more challenging to implement.

摘要

近龄同伴教学在医院轮转培训中被广泛应用,但在门诊护理中的应用研究较少。本研究的目的是验证在其他环境中发现的近龄同伴教学的益处,并探讨初级保健特有的近龄同伴临床督导的益处和挑战。为此选择了采用半结构化访谈的定性描述性设计。一名带教教师指导高级家庭医学住院医师,而这些高级住院医师再去督导一名初级住院医师。然后我们了解住院医师对这段经历的看法。该研究在加拿大的一个家庭医学教学单位进行。六名一年级和三名二年级家庭医学住院医师参与了研究。初级和高级住院医师都认为近龄同伴临床督导应成为家庭医学住院医师培训期间的一个选项。高级住院医师被认为受益最大。近龄同伴教学被发现能促进督导住院医师的自我反思和自信心。住院医师们觉得需要有带教教师进行观察。总之,先前在医院环境中描述的近龄同伴教学的益处可以扩展到门诊护理培训项目。然而,在初级保健环境中对直接观察的明显需求可能使其实施更具挑战性。

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