Eden Aimee R, Peterson Lars E
American Board of Family Medicine, Lexington, KY.
Fam Med. 2017 Jan;49(1):14-21.
Advanced maternity care training in family medicine is highly variable at both the residency and fellowship levels. Declining numbers of family physicians providing maternity care services may exacerbate disparities in access to maternal and child care, especially in rural and other underserved communities. Accreditation of maternity care fellowships and board certification may be one potential avenue to address this trend. This study sought to understand the perceptions and beliefs of key family medicine stakeholders in advanced maternity care regarding the formalization of maternity care training through fellowship accreditation and the creation of a certificate of added qualification (CAQ).
In 2014 and 2015, the authors conducted semi-structured interviews with 51 key stakeholders in family medicine maternity care. Transcribed interviews were coded using an iterative process to identify themes and patterns until saturation was reached.
Participants generally supported both maternity care fellowship accreditation and a CAQ and recognized multiple advantages such as legitimization of training. Many had concerns about potential negative unintended consequences such as a loss of curricular flexibility; however, most felt that these could be mediated. Only a few did not support one or both aspects of formalization.
Most participants interviewed support formalizing maternity care fellowship training in family medicine through accreditation and a subsequent CAQ, if implemented with attention to minimizing the potential negative consequences. Such formalization would recognize the advanced skill and training of family physicians practicing advanced maternity care and could address some access issues to essential maternity care services for rural and other underserved populations.
家庭医学领域的高级产科护理培训在住院医师和专科医师培训阶段差异很大。提供产科护理服务的家庭医生数量不断减少，这可能会加剧母婴护理可及性方面的差距，尤其是在农村和其他服务不足的社区。产科护理专科医师培训认证和委员会认证可能是解决这一趋势的一个潜在途径。本研究旨在了解家庭医学领域关键利益相关者对通过专科医师培训认证和设立附加资格证书（CAQ）来规范产科护理培训的看法和信念。
2014年和2015年，作者对51位家庭医学产科护理领域的关键利益相关者进行了半结构化访谈。对转录的访谈内容进行编码，采用迭代过程来识别主题和模式，直至达到饱和状态。
参与者普遍支持产科护理专科医师培训认证和CAQ，并认识到多项优势，如培训的合法化。许多人担心可能产生的负面意外后果，如课程灵活性的丧失；然而，大多数人认为这些可以得到调节。只有少数人不支持规范化的一个或两个方面。
大多数接受访谈的参与者支持通过认证和后续的CAQ来规范家庭医学中的产科护理专科医师培训，如果实施时注意尽量减少潜在的负面后果。这种规范化将认可从事高级产科护理的家庭医生的先进技能和培训，并可以解决农村和其他服务不足人群在基本产科护理服务可及性方面的一些问题。
