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让医学生为真实患者提供患者教育:范围综述。

Involving Medical Students in Providing Patient Education for Real Patients: A Scoping Review.

机构信息

Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, The Netherlands.

Radboud University Medical Center, Radboudumc Health Academy, Department for Research in Learning and Education, Nijmegen, The Netherlands.

出版信息

J Gen Intern Med. 2017 Sep;32(9):1031-1043. doi: 10.1007/s11606-017-4065-3. Epub 2017 Jun 9.

Abstract

BACKGROUND

Studies suggest that involving students in patient education can contribute to the quality of care and medical education. Interventions and outcomes in this field, however, have not yet been systematically reviewed. The authors examined the scientific literature for studies on interventions and outcomes of student-provided patient education.

METHODS

Four databases (MEDLINE, EMBASE, ERIC, PsycINFO) were searched for studies reporting patient education, undergraduate medical students, and outcomes of patient education, published between January 1990 and October 2015. Facilitators of and barriers to educational interventions were assessed using the Learning Transfer System Inventory. The learning yield, impact on quality of care, and practical feasibility of the interventions were rated by patients, care professionals, researchers, and education professionals.

RESULTS

The search resulted in 4991 hits. Eighteen studies were included in the final synthesis. Studies suggested that student-provided patient education improved patients' health knowledge, attitude, and behavior (nine studies), disease management (three studies), medication adherence (one study), and shared decision-making (one study). In addition, involving students in patient education was reported to enhance students' patient education self-efficacy (four studies), skills (two studies), and behavior (one study), their relationships with patients (two studies), and communication skills (two studies).

DISCUSSION

Our findings suggest that student-provided patient education-specifically, student-run patient education clinics, student-provided outreach programs, student health coaching, and clerkships on patient education-has the potential to improve quality of care and medical education. To enhance the learning effectiveness and quality of student-provided patient education, factors including professional roles for students, training preparation, constructive supervision, peer support on organizational and individual levels, and learning aids should be taken into account. Future research should focus on further investigating the effects found in this study with high-level evidence.

摘要

背景

研究表明,让学生参与患者教育有助于提高医疗质量和医学教育水平。然而,该领域的干预措施和结果尚未得到系统评价。作者检索了关于学生提供患者教育的干预措施和结果的研究文献。

方法

检索了四个数据库(MEDLINE、EMBASE、ERIC、PsycINFO),检索时间为 1990 年 1 月至 2015 年 10 月,检索词包括“patient education”“undergraduate medical students”和“outcomes of patient education”,旨在查找报告患者教育、本科医学生和患者教育结果的研究。使用学习转移系统清单评估教育干预的促进因素和障碍。患者、护理专业人员、研究人员和教育专业人员对干预措施的学习效果、对护理质量的影响和实际可行性进行了评价。

结果

搜索结果为 4991 条记录,最终有 18 项研究被纳入综合分析。研究表明,学生提供的患者教育可提高患者的健康知识、态度和行为(9 项研究)、疾病管理(3 项研究)、药物依从性(1 项研究)和共同决策(1 项研究)。此外,有研究报告称,让学生参与患者教育可增强学生的患者教育自我效能感(4 项研究)、技能(2 项研究)和行为(1 项研究),改善学生与患者的关系(2 项研究)和沟通技巧(2 项研究)。

讨论

本研究结果表明,学生提供的患者教育(特别是学生经营的患者教育诊所、学生提供的外展项目、学生健康指导以及患者教育实习)具有提高医疗质量和医学教育水平的潜力。为了提高学生提供患者教育的学习效果和质量,应考虑学生的专业角色、培训准备、建设性监督、组织和个人层面的同伴支持以及学习辅助工具等因素。未来的研究应重点利用高质量证据进一步调查本研究中发现的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9846/5570739/4dc50e82b5ef/11606_2017_4065_Fig1_HTML.jpg

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