Leedham-Green Kathleen E, Pound Rebecca, Wylie Ann
a Department of Primary Care and Public Health Sciences , King's College London , London , UK.
b Faculty of Life Sciences and Medicine , King's College London GKT School of Medical Education, Guy's Campus , London , UK.
Educ Prim Care. 2016 Nov;27(6):455-461. doi: 10.1080/14739879.2016.1205459. Epub 2016 Jul 14.
Obesity is a leading risk factor for morbidity and mortality, however, guidelines for prevention and management are relatively recently established. Little is known about what needs to be in place to put these into practice. This research provides an insight into how senior medical students consult with obese patients in general practice, the range of their learning needs, and the impact of various educational strategies that aim to bring their practice closer to current evidence-based guidelines. It centres on a series of compulsory but formative reflective case studies written by final year students at one large medical school on their GP rotation as they consult independently with obese patients with 'next room' GP tutor support. Analysis of these case studies was used to inform a three-year educational action research project. By systematically identifying and addressing learning needs, including barriers and enablers to best practice, we have demonstrated how senior medical students, and their GP tutors, can acquire the role legitimacy and role competency required for effective practice.
肥胖是发病和死亡的主要风险因素，然而，预防和管理指南是最近才制定的。对于将这些指南付诸实践需要具备哪些条件，人们知之甚少。本研究深入探讨了高年级医学生在全科医疗中如何与肥胖患者进行咨询，他们的学习需求范围，以及旨在使他们的实践更接近当前循证指南的各种教育策略的影响。它以一所大型医学院最后一年学生在全科医生轮转期间撰写的一系列必修但形成性的反思性案例研究为中心，这些学生在“隔壁房间”全科医生导师的支持下独立与肥胖患者进行咨询。对这些案例研究的分析为一个为期三年的教育行动研究项目提供了信息。通过系统地识别和解决学习需求，包括最佳实践的障碍和促进因素，我们展示了高年级医学生及其全科医生导师如何获得有效实践所需的角色合法性和角色能力。
