Silk Hugh, Savageau Judith A, Sullivan Kate, Sawosik Gail, Wang Min
University of Massachusetts Medical School Worcester, MA.
Department of Family Medicine & Community Health, University of Massachusetts Medical School, Worcester, MA.
Fam Med. 2018 Jun;50(6):437-443. doi: 10.22454/FamMed.2018.372427.
National initiatives have encouraged oral health training for family physicians and other nondental providers for almost 2 decades. Our national survey assesses progress of family medicine residency programs on this important health topic since our last survey in 2011.
Family medicine residency program directors (PDs) completed an online survey covering various themes including number of hours of oral health (OH) teaching, topics covered, barriers, evaluation, positive influences, and program demographics.
Compared to 2011, more PDs feel OH should be addressed by physicians (86% in 2017 vs 79% in 2011), yet fewer programs are teaching OH (81% vs 96%) with fewer hours overall (31% vs 45% with 4 or more hours). Satisfaction with the competence of graduating residents in OH significantly decreased (17% in 2017 vs 32% in 2011). Program directors who report graduates being well prepared to answer board questions on oral health topics are more likely to have an oral health champion (P<0.001) and report satisfaction with the graduates' level of oral health competency (P<0.001). Programs with an oral health champion, or having a relationship with a state or national oral health coalition, or having routine teaching from a dental professional are significantly more likely to have more hours of oral health curriculum (P<0.001).
Family medicine PDs are more aware of the importance of oral health, yet less oral health is being taught in residency programs. Developing more faculty oral health champions and connecting programs to dental faculty and coalitions may help reduce this educational void.
近20年来，国家一直在推动针对家庭医生及其他非牙科医疗服务提供者的口腔健康培训。本次全国性调查评估了自2011年我们上次调查以来，家庭医学住院医师培训项目在这一重要健康主题上的进展情况。
家庭医学住院医师培训项目主任完成了一项在线调查，内容涵盖多个主题，包括口腔健康教学时长、所涵盖的主题、障碍、评估、积极影响以及项目的人口统计学信息。
与2011年相比，更多的项目主任认为医生应关注口腔健康（2017年为86%，2011年为79%），但开展口腔健康教学的项目减少了（81%对96%），总体教学时长也减少了（4小时及以上的项目从45%降至31%）。对住院医师毕业时口腔健康能力的满意度显著下降（2017年为17%，2011年为32%）。报告毕业生准备充分以回答口腔健康主题委员会问题的项目主任，更有可能有一位口腔健康倡导者（P<0.001），并对毕业生的口腔健康能力水平表示满意（P<0.001）。有口腔健康倡导者、与州或国家口腔健康联盟有关系，或有牙科专业人员进行常规教学的项目，更有可能有更多时长的口腔健康课程（P<0.001）。
家庭医学项目主任更意识到口腔健康的重要性，但住院医师培训项目中开展的口腔健康教学却减少了。培养更多的教师口腔健康倡导者，并将项目与牙科教师和联盟联系起来，可能有助于减少这一教育空白。
