社会责任感医学教育：佛罗里达国际大学赫尔伯特·沃特海姆医学院的创新方法。

Socially Accountable Medical Education: An Innovative Approach at Florida International University Herbert Wertheim College of Medicine.

机构信息

P.J. Greer Jr is professor and chair, Department of Humanities, Health, and Society, and associate dean, Community Engagement, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0001-6682-8204. D.R. Brown is associate professor and chief, Division of Family and Community Medicine, and vice chair, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-5361-6664. L.G. Brewster is associate professor and chief, Division of Policy and Community Development, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0001-8067-3667. O.G. Lage is associate professor and vice chair, Education and Faculty Development, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-2121-4687. K.F. Esposito is professor, Department of Psychiatry and Behavioral Sciences, and associate dean, Curriculum and Medical Education, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-3988-235X. E.B. Whisenant is assistant professor, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-1100-1565. F.W. Anderson is assistant professor and medical director, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0003-4750-5236. N.K. Castellanos is assistant professor, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-4393-4191. T.A. Stefano is consultant, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-6972-5873. J.A. Rock is professor, Department of Obstetrics and Gynecology, dean, Herbert Wertheim College of Medicine, and senior vice president, Health Affairs, Florida International University, Miami, Florida; ORCID: http://orcid.org/0000-0002-9970-8417.

出版信息

Acad Med. 2018 Jan;93(1):60-65. doi: 10.1097/ACM.0000000000001811.

DOI:10.1097/ACM.0000000000001811

PMID:28658020

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5753826/

Abstract

PROBLEM

Despite medical advances, health disparities persist, resulting in medicine's renewed emphasis on the social determinants of health and calls for reform in medical education.

APPROACH

The Green Family Foundation Neighborhood Health Education Learning Program (NeighborhoodHELP) at Herbert Wertheim College of Medicine provides a platform for the school's community-focused mission. NeighborhoodHELP emphasizes social accountability and interprofessional education while providing evidence-based, patient- and household-centered care. NeighborhoodHELP is a required, longitudinal service-learning outreach program in which each medical student is assigned a household in a medically underserved community. Students, teamed with learners from other professional schools, provide social and clinical services to their household for three years. Here the authors describe the program's engagement approach, logistics, and educational goals and structure.

OUTCOMES

During the first six years of NeighborhoodHELP (September 2010-August 2016), 1,470 interprofessional students conducted 7,452 visits to 848 households with, collectively, 2,252 members. From August 2012, when mobile health centers were added to the program, through August 2016, students saw a total of 1,021 household members through 7,207 mobile health center visits. Throughout this time, households received a variety of free health and social services (e.g., legal aid, tutoring). Compared with peers from other schools, graduating medical students reported more experience with clinical interprofessional education and health disparities. Surveyed residency program directors rated graduates highly for their cultural sensitivity, teamwork, and accountability.

NEXT STEPS

Faculty and administrators are focusing on social accountability curriculum integration, systems for assessing and tracking relevant educational and household outcomes, and policy analysis.

摘要

问题

尽管医学取得了进步，但健康差距仍然存在，这导致医学重新强调健康的社会决定因素，并呼吁改革医学教育。

方法

赫伯特·沃特海姆医学院的格林家族基金会邻里健康教育学习计划（邻里 HELP）为学校以社区为中心的使命提供了一个平台。邻里 HELP 强调社会责任和跨专业教育，同时提供基于证据、以患者和家庭为中心的护理。邻里 HELP 是一项必修的、纵向的服务学习外展计划，每个医学生都被分配到一个医疗服务不足社区的家庭。学生与来自其他专业学校的学习者一起，为他们的家庭提供三年的社会和临床服务。在这里，作者描述了该计划的参与方法、后勤和教育目标及结构。

结果

在邻里 HELP 的头六年（2010 年 9 月至 2016 年 8 月），1470 名跨专业学生对 848 个家庭进行了 7452 次访问，这些家庭共有 2252 名成员。从 2012 年 8 月，当移动医疗中心被添加到该计划，到 2016 年 8 月，学生通过 7207 次移动医疗中心访问总共看到了 1021 名家庭成员。在此期间，家庭获得了各种免费的健康和社会服务（例如，法律援助，辅导）。与其他学校的同龄人相比，即将毕业的医学生报告说，他们在临床跨专业教育和健康差距方面有更多的经验。接受调查的住院医师项目主任高度评价毕业生的文化敏感性、团队合作能力和责任感。