Weiland Gustave, Cox Kathryn, Sweeney Mary Katherine, Belue Michael, Snyder Erin D, Curry William D, Evans H Hughes, Salser B Earl, Estrada Carlos A
From the Departments of Medicine and Family and Community Medicine, University of Alabama at Birmingham, Birmingham, the Department of Medical Education, University of Alabama School of Medicine, Birmingham, and Emory University School of Medicine, Atlanta, Georgia.
South Med J. 2019 Feb;112(2):76-82. doi: 10.14423/SMJ.0000000000000933.
To examine the perceptions of first-year medical students on their experiences in primary care.
Nominal group technique sessions were conducted with first-year medical students for 5 years. Questions were designed to evaluate primary care experiences and the role of primary care physicians. The questions explored what would make them consider primary care, what would detract from it, and what primary care has to offer that no other specialty can. Responses were weighted and ranked. The main outcome was the top five responses to three questions that were obtained at each session.
Thirty-four students generated 280 responses to 3 questions. The top 5 responses for each year resulted in 29 experiences that strengthen enthusiasm: patient interactions (weighted sum, 43%), physician interactions/role modeling (22%), community interactions (20%), healthcare system/finances (8%), and other (6%). The top 5 responses resulted in 26 experiences that weaken enthusiasm, including hidden curriculum (45%), poor role models (29%), uncertainties about the healthcare system such as finances and documentation (20%), and patient interactions (6%). The top 5 responses regarding the uniqueness of primary care resulted in 37 experiences, including patient interactions (38%), continuity of care (20%), knowledge base (13%), community impact (10%), lifestyle benefits (10%), and education/prevention (9%).
Medical students highlighted unique relationships with patients and continuity of care as experiences that increase their enthusiasm for primary care. Negative experiences that weakened enthusiasm for primary care included hidden curriculum and poor role models. Programs that provide experiences in primary care can increase student interest in primary care careers.
研究一年级医学生对其基层医疗经历的看法。
对一年级医学生进行了为期5年的名义小组技术会议。设计问题以评估基层医疗经历和基层医疗医生的角色。问题探讨了哪些因素会使他们考虑从事基层医疗，哪些因素会减少这种考虑，以及基层医疗能提供而其他专科无法提供的东西。对回答进行加权和排序。主要结果是每次会议上对三个问题的前五项回答。
34名学生对3个问题给出了280个回答。每年的前五项回答产生了29种增强热情的经历：与患者互动（加权总和，43%）、与医生互动/榜样作用（22%）、社区互动（20%）、医疗系统/财务（8%）和其他（6%）。前五项回答产生了26种削弱热情的经历，包括隐性课程（45%）、榜样不佳（29%）、医疗系统的不确定性，如财务和文件记录（20%）以及与患者互动（6%）。关于基层医疗独特性的前五项回答产生了37种经历，包括与患者互动（38%）、连续护理（20%）、知识库（13%）、社区影响（10%）、生活方式益处（10%）和教育/预防（9%）。
医学生强调与患者的独特关系和连续护理是增加他们对基层医疗热情的经历。削弱对基层医疗热情的负面经历包括隐性课程和榜样不佳。提供基层医疗经历的项目可以增加学生对基层医疗职业的兴趣。
