Lochner Jennifer, Lankton Robin, Rindfleish Kirsten, Arndt Brian, Edgoose Jennifer
Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Fam Med. 2018 Jul;50(7):518-525. doi: 10.22454/FamMed.2018.118276.
Improvement in population health has become a key goal of health systems and payers in the United States. Because 80% of health outcomes are driven by social determinants of health beyond medical care and health care access, such improvements require attention to factors outside of the conventional areas of expertise for clinicians. Yet primary care physicians often graduate from training programs with few skills in population and community health.
In 2011, the University of Wisconsin Department of Family Medicine began transformative work to become a Department of Family Medicine and Community Health (DFMCH). As part of this effort, educators in the department addressed deficiencies in its residency's community and population health curriculum by implementing curricular change and faculty development. A set of guiding principles, "Three Community Health Responsibilities for Family Doctors," was developed to provide background and structure to current and future work.
An annual program evaluation survey was administered to faculty and residents between 2012 and 2016. Respondents reported a significant increase in their understanding of population and community health over the prior year in each year this was assessed (P<0.001).
Community and population health principles have become part of the fabric of the entire residency curriculum in the DFMCH. Faculty development was a key part of this work and will be integral to sustaining improvements.
改善人群健康已成为美国卫生系统和医保支付方的关键目标。由于80%的健康结果是由医疗保健和医疗服务可及性之外的健康社会决定因素驱动的,因此要实现此类改善,就需要关注临床医生传统专业领域之外的因素。然而,初级保健医生在完成培训项目毕业时,往往缺乏人群和社区健康方面的技能。
2011年,威斯康星大学家庭医学系开始进行变革性工作,转型为家庭医学与社区健康系(DFMCH)。作为这项工作的一部分,该系的教育工作者通过实施课程改革和师资发展来解决其住院医师培训项目在社区和人群健康课程方面的不足。制定了一套指导原则,即“家庭医生的三项社区健康职责”,为当前及未来的工作提供背景和架构。
在2012年至2016年期间,对教职员工和住院医师进行了年度项目评估调查。在每次评估的年份中,受访者报告称他们对人群和社区健康的理解较上一年有显著提高(P<0.001)。
社区和人群健康原则已成为DFMCH整个住院医师培训课程的一部分。师资发展是这项工作的关键部分,对于维持改进至关重要。