Shaffer Robyn, Piro Nancy, Katznelson Laurence, Gephart Melanie Hayden
Stanford School of Medicine, California, USA.
Department of Graduate Medical Education, Stanford School of Medicine, California, USA.
Clin Teach. 2017 Oct;14(5):344-348. doi: 10.1111/tct.12593. Epub 2017 Feb 6.
Debt repayment, professional negotiation and practice management skills are vital to a successful medical practice, yet are undervalued and seldom taught in graduate medical education. Medical residents need additional training to confidently transition to independent practice, requiring the development of novel curricula. Medical residents need additional training to confidently transition to independent practice METHODS: We developed a trial practice management curriculum to educate senior residents and fellows through voluntary workshops. Topics discussed in the workshops included debt repayment, billing compliance, medical malpractice, contract negotiations, and lifestyle and financial management. Resident self-confidence was assessed, and feedback was obtained through voluntary survey responses before and after attendance at a workshop, scored using a Likert scale.
Twenty-five residents from 20 specialties attended a 1-day session incorporating all lectures; 53 residents from 17 specialties attended a re-designed quarterly session with one or two topics per session. Survey evaluations completed before and after the workshop demonstrated an improvement in residents' self-assessment of confidence in contract negotiations (p < 0.001) and their first year in practice (p < 0.001): after the curriculum, 94 per cent (n = 42) of respondents felt confident participating in contract negotiations, and 93 per cent (n = 38) of respondents felt confident about their first year in practice. One hundred per cent of respondents agreed that the presentation objectives were relevant to their needs as residents.
Participant responses indicated a need for structured education in practice management for senior trainees. Senior residents and fellows will benefit most from curricula, but have high familial and professional demands on their schedules.
债务偿还、专业谈判和实践管理技能对成功开展医疗业务至关重要，但在毕业后医学教育中却被低估且很少教授。住院医师需要额外培训才能自信地过渡到独立执业，这需要开发新的课程。
我们开发了一个试行的实践管理课程，通过自愿参加的研讨会对高年级住院医师和研究员进行培训。研讨会上讨论的主题包括债务偿还、计费合规、医疗事故、合同谈判以及生活方式和财务管理。评估住院医师的自信心，并通过参加研讨会前后自愿填写的调查问卷获得反馈，调查问卷采用李克特量表评分。
来自20个专业的25名住院医师参加了包含所有讲座的为期1天的课程；来自17个专业的53名住院医师参加了重新设计的季度课程，每次课程有一两个主题。研讨会前后完成的调查评估显示，住院医师对合同谈判（p < 0.001）和执业第一年（p < 0.001）的自信心自我评估有所提高：课程结束后，94%（n = 42）的受访者对参与合同谈判感到自信，93%（n = 38）的受访者对执业第一年感到自信。100%的受访者认为讲座目标与他们作为住院医师的需求相关。
参与者的反馈表明，高年级学员需要接受实践管理方面的结构化教育。高年级住院医师和研究员将从课程中受益最多，但他们的日程安排面临着较高的家庭和专业要求。
