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儿科住院医师在线与面对面筛查、简短干预及转介治疗培训

Online Versus In-Person Screening, Brief Intervention, and Referral to Treatment Training in Pediatrics Residents.

作者信息

Giudice Erin L, Lewin Linda O, Welsh Christopher, Crouch Taylor Berens, Wright Katherine S, Delahanty Janine, DiClemente Carlo C

出版信息

J Grad Med Educ. 2015 Mar;7(1):53-8. doi: 10.4300/JGME-D-14-00367.1.

Abstract

BACKGROUND

Pediatricians underestimate the prevalence of substance misuse among children and adolescents and often fail to screen for and intervene in practice. The American Academy of Pediatrics recommends training in Screening, Brief Intervention, and Referral to Treatment (SBIRT), but training outcomes and skill acquisition are rarely assessed.

OBJECTIVE

We compared the effects of online versus in-person SBIRT training on pediatrics residents' knowledge, attitudes, behaviors, and skills.

METHODS

Forty pediatrics residents were randomized to receive either online or in-person training. Skills were assessed by pre- and posttraining standardized patient interviews that were coded for SBIRT-adherent and -nonadherent behaviors and global skills by 2 trained coders. Thirty-two residents also completed pre- and postsurveys of their substance use knowledge, attitudes, and behaviors (KABs). Two-way repeated measures multivariate analyses of variance (MANOVAs) and analyses of variance (ANOVAs) estimates were used to assess group differences in skill acquisition and KABs.

RESULTS

Findings indicated that both groups demonstrated skill improvement from pre- to postassessment. Results indicated that both groups increased their knowledge, self-reported behaviors, confidence, and readiness with no significant between-group differences. Follow-up univariate analyses indicated that, while both groups increased their SBIRT-adherent skills, the online training group displayed more "undesirable" behaviors posttraining.

CONCLUSIONS

The current study indicates that brief training, online or in-person, can increase pediatrics residents' SBIRT skills, knowledge, self-reported behaviors, confidence, and readiness. The findings further indicate that in-person training may have incremental benefit in teaching residents what not to do.

摘要

背景

儿科医生低估了儿童和青少年药物滥用的患病率,并且在实际工作中常常未能进行筛查和干预。美国儿科学会建议开展筛查、简短干预及转介治疗(SBIRT)培训,但很少评估培训效果和技能掌握情况。

目的

我们比较了在线SBIRT培训与面对面SBIRT培训对儿科住院医师知识、态度、行为和技能的影响。

方法

40名儿科住院医师被随机分为接受在线培训或面对面培训两组。通过培训前后的标准化患者访谈评估技能,由两名经过培训的编码人员对符合和不符合SBIRT的行为以及整体技能进行编码。32名住院医师还完成了关于药物使用知识、态度和行为(KABs)的培训前和培训后调查。采用双向重复测量多元方差分析(MANOVA)和方差分析(ANOVA)估计来评估两组在技能掌握和KABs方面的差异。

结果

研究结果表明,两组在评估前到评估后的技能均有提高。结果表明,两组在知识、自我报告行为、信心和准备程度方面均有所提高,组间无显著差异。后续单变量分析表明,虽然两组符合SBIRT的技能均有所提高,但在线培训组在培训后表现出更多“不良”行为。

结论

当前研究表明,无论是在线培训还是面对面培训,简短的培训都可以提高儿科住院医师的SBIRT技能、知识、自我报告行为、信心和准备程度。研究结果还表明,面对面培训在教导住院医师避免错误行为方面可能有额外的益处。

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