Loh Tiffany, Vazirnia Aria, Afshar Maryam, Dorschner Robert, Paravar Taraneh
Department of Dermatology, University of California San Diego, La Jolla, California.
Dermatol Online J. 2017 May 15;23(5):13030/qt39n4p5d6.
As established by the AccreditationCouncil for Graduate Medical Education (ACGME),dermatology residents in the United States must participate in continuity clinic. This requirement may be achieved through multiple means, allowing for program variation. To better assess continuity clinic's role in resident learning, more data on this component of graduate medical education is needed.
An anonymous online survey was distributed via the American Board of Dermatology list serv to all U.S. dermatology residents. Continuity clinic organization, setting, frequency, and patient and preceptor characteristics were assessed; resident satisfaction and learning were compared.
Of 231 responses, 7.8% reported continuity clinic daily, 77.1% weekly, 9.1% every other week, 3.0%monthly, 0.4% once every several months, and 2.2%only during certain blocks. Of the clinics reported,80.1% were "resident-run with attending" and 11.3%were attending-run. The rest were "resident-run with no attending" (0.9%), both resident and attending run(3.0%), or "other" (4.8%). Trainees in resident-run clinics (with attendings) reported greater continuity of care than those in attending-run clinics (p<0.001).Residents reported better teaching with attending presence during patient encounters than when attendings were present only if concerns were raised(p<0.01).
根据研究生医学教育认证委员会（ACGME）的规定，美国皮肤科住院医师必须参与连续性门诊。这一要求可通过多种方式实现，从而允许项目存在差异。为了更好地评估连续性门诊在住院医师学习中的作用，需要更多关于研究生医学教育这一组成部分的数据。
通过美国皮肤科委员会的邮件列表向所有美国皮肤科住院医师发放了一份匿名在线调查问卷。对连续性门诊的组织、地点、频率以及患者和带教老师的特征进行了评估；比较了住院医师的满意度和学习情况。
在231份回复中，7.8%的人报告每天参与连续性门诊，77.1%的人每周参与，9.1%的人每隔一周参与，3.0%的人每月参与，0.4%的人每隔几个月参与一次，2.2%的人仅在特定时间段参与。在所报告的门诊中，80.1%是“住院医师主导且有主治医生参与”，11.3%是主治医生主导。其余的是“住院医师主导且无主治医生参与”（0.9%）、住院医师和主治医生共同主导（3.0%）或“其他”（4.8%）。在住院医师主导的门诊（有主治医生参与）中的受训者报告的护理连续性比在主治医生主导的门诊中的受训者更高（p<0.001）。住院医师报告说，在患者诊疗过程中有主治医生在场时的教学效果比只有在提出问题时主治医生在场时更好（p<0.01）。
