Reitz Randall, Sudano Laura, Siler Anne, Trimble Kristopher
St Mary's Family Medicine Residency, Grand Junction, CO.
Fam Med. 2016 May;48(5):359-65.
Great variety exists in the roles that family medicine residency faculty fill in the lives of their residents. A family medicine-specific model has never been created to describe and promote effective training relationships. This research aims to create a consensus model for faculty development, ethics education, and policy creation.
Using a modified grounded theory methods, researchers conducted phone interviews with 22 key informants from US family medicine residencies. Data were analyzed to delineate faculty roles, common role conflicts, and ethical principles for avoiding and managing role conflicts. Key informants were asked to apply their experience and preferences to adapt an existing model to fit with family medicine residency settings.
The primary result of this research is the creation of a family medicine-specific model that describes faculty roles and provides insight into how to manage role conflicts with residents. Primary faculty roles include Role Model, Advisor, Teacher, Supervisor, and Evaluator. Secondary faculty roles include Friendly Colleague, Wellness Supporter, and Helping Hand. The secondary roles exist on a continuum from disengaged to enmeshed. When not balanced, the secondary roles can detract from the primary roles. Differences were found between role expectations of physician versus behavioral science faculty and larger/university/urban residencies versus smaller/community/rural residencies.
Diversity of opinion exists related to the types of roles that are appropriate for family medicine faculty to maintain with residents. This new model is a first attempt to build consensus in the field and has application to faculty development, ethics education, and policy creation.
家庭医学住院医师培训项目的教员在住院医师的生活中扮演着多种多样的角色。目前尚未创建一个专门针对家庭医学的模型来描述和促进有效的培训关系。本研究旨在创建一个关于教员发展、伦理教育和政策制定的共识模型。
研究人员采用改良的扎根理论方法,对来自美国家庭医学住院医师培训项目的22名关键信息提供者进行了电话访谈。对数据进行分析,以确定教员的角色、常见的角色冲突以及避免和管理角色冲突的伦理原则。要求关键信息提供者运用他们的经验和偏好,对现有的模型进行调整,以适应家庭医学住院医师培训的环境。
本研究的主要成果是创建了一个专门针对家庭医学的模型,该模型描述了教员的角色,并深入探讨了如何管理与住院医师的角色冲突。教员的主要角色包括榜样、顾问、教师、督导和评估者。次要角色包括友好同事、健康支持者和帮手。次要角色存在一个从疏离到紧密的连续体。如果不平衡,次要角色可能会影响主要角色。研究发现,医生与行为科学教员的角色期望以及大型/大学/城市住院医师培训项目与小型/社区/农村住院医师培训项目的角色期望存在差异。
对于家庭医学教员与住院医师保持何种合适的角色类型,存在意见分歧。这个新模型是在该领域建立共识的首次尝试,适用于教员发展、伦理教育和政策制定。