Boggiano Victoria L, Wu Yufan, Bruce Janine S, Merrell Sylvia Bereknyei, Schillinger Erika
School of Medicine, Stanford University.
Fam Med. 2017 Jan;49(1):57-61.
The patient-centered care model for health care delivery encourages medical providers to respect patients' preferences and give patients more autonomy over their health care decisions. This approach has gained importance within US medical school curricula. Yet, little is known about student perspectives on both patient-centered care and the benefits and challenges that lie therein. This manuscript explores the greatest impediments to, as well as the benefits from, student engagement in patient-centered care from the perspectives of students participating in their family medicine outpatient clerkship.
Clerkship students on their core family medicine clerkship at Stanford University School of Medicine were provided the following open-ended prompt: "Describe a patient-centered care challenge or surprise in the family medicine core clerkship." Free-text responses were collected and analyzed using content and thematic analysis.
A total of 326 responses from 216 students were analyzed for frequency and patient-centered themes. Nine final themes emerged and were grouped into three domains: student definitions of patient-centered care, patient-centered care impact on patients, and patient-centered care impact on medical professionals.
Our study suggests that students find the patient-centered care model for health care delivery to be challenging but worthwhile. We highlight that students find communication with patients in a patient-centered manner challenging and discuss the need for improved medical education about patient-centered care in order to better prepare students to implement the model in a variety of psychosocial and medical contexts.
以患者为中心的医疗服务模式鼓励医疗服务提供者尊重患者的偏好，并给予患者在医疗决策上更多的自主权。这种方法在美国医学院课程中变得越来越重要。然而，对于学生对以患者为中心的医疗服务及其所带来的益处和挑战的看法，我们知之甚少。本论文从参与家庭医学门诊实习的学生视角，探讨了学生参与以患者为中心的医疗服务所面临的最大障碍以及从中获得的益处。
斯坦福大学医学院核心家庭医学实习的学生收到了以下开放式提示：“描述家庭医学核心实习中以患者为中心的医疗服务挑战或意外情况。”收集自由文本回复并使用内容和主题分析进行分析。
对216名学生的326份回复进行了频率和以患者为中心主题的分析。出现了九个最终主题，并分为三个领域：学生对以患者为中心的医疗服务的定义、以患者为中心的医疗服务对患者的影响以及以患者为中心的医疗服务对医疗专业人员的影响。
我们的研究表明，学生发现以患者为中心的医疗服务模式具有挑战性但很有价值。我们强调，学生发现以患者为中心的方式与患者沟通具有挑战性，并讨论了改进以患者为中心的医疗服务医学教育的必要性，以便更好地让学生在各种心理社会和医疗背景下实施该模式。
