DeMarco Mario P, Betancourt Renée M, Everard Kelly M, Bream Kent D W
Department of Family Medicine and Community Health, University of Pennsylvania.
Department of Family Medicine, Saint Louis University School of Medicine, St Louis, MO.
Fam Med. 2018 Jan;50(1):36-40. doi: 10.22454/FamMed.2018.994360.
Many patients with behavioral health disorders do not seek or receive adequate care for their conditions. Among those that do, most will receive care in a primary care setting. To best meet this need, clinicians will need to demonstrate proficiency of behavioral health skills and evidence-based practices. We sought to explore the degree to which these skills are being taught in family medicine clerkships.
The Council of Academic Family Medicine's (CAFM) Educational Research Alliance (CERA) 2016 survey of clerkship directors (CDs) was sent to 141 CDs at US and Canadian medical schools with a required family medicine run course. CDs were asked about the inclusion of behavioral health topics, tools, and techniques in the clerkship, as well as rating the importance of these items.
Eighty-six percent of CDs completed the survey. Mood disorders (81.4%) were most frequently taught, followed by anxiety disorders (77.8%), substance use disorders (74.4%), and impulse control disorders (39.1%). Screening tools and behavioral health counseling skills were less commonly taught.
Many behavioral health topics are not taught universally to all family medicine clerkship students. Gaps exist between what is included in current curriculum and what is recommended by the National Clerkship Curriculum for family medicine. These gaps may represent challenges for improving the care for patients with behavioral health disorders.
许多患有行为健康障碍的患者并未寻求或获得针对其病情的充分治疗。在那些寻求治疗的患者中，大多数会在初级保健机构接受治疗。为了最好地满足这一需求，临床医生需要展示行为健康技能和循证实践的熟练程度。我们试图探究在家庭医学实习中这些技能的教授程度。
学术家庭医学委员会（CAFM）的教育研究联盟（CERA）2016年对实习主任（CDs）的调查被发送给美国和加拿大医学院的141名实习主任，这些医学院设有必修的家庭医学课程。实习主任们被问及在实习中行为健康主题、工具和技术的纳入情况，以及对这些项目重要性的评分。
86%的实习主任完成了调查。情绪障碍（81.4%）是最常教授的内容，其次是焦虑障碍（77.8%）、物质使用障碍（74.4%）和冲动控制障碍（39.1%）。筛查工具和行为健康咨询技能较少被教授。
许多行为健康主题并非普遍教授给所有家庭医学实习学生。当前课程所涵盖的内容与家庭医学国家实习课程所推荐的内容之间存在差距。这些差距可能对改善行为健康障碍患者的护理构成挑战。
