Mazurkiewicz Rebecca, Ryan Emily, Rackman Alexander
Physician of Internal Medicine, Lenox Hill Hospital.
Director of Primary Care Track, Lenox Hill Hospital.
MedEdPORTAL. 2016 Jun 24;12:10420. doi: 10.15766/mep_2374-8265.10420.
Internal medicine (IM) residents must be capable of performing ambulatory procedures required of a competent internist regardless of their career plans. Unfortunately, many IM residents may feel uncomfortable in the ambulatory setting and with ambulatory procedures as the bulk of residency training focuses on inpatient experiences.
The session described here is a 1.5-hour case-based, interactive module for residents of all training levels centered on key ambulatory procedures, featuring experienced faculty demonstrating said procedures on a realistic, full-body manikin patient care simulator followed by direct observation of resident competence by that faculty member. Four students per group is optimal. As clinician educators serve as facilitators, faculty training is limited to a walk-through of each session. The materials associated with this publication include the session protocol, cases, direct observation procedure checklists, preparticipation surveys, and postparticipation surveys.
From July 2014 to June 2015, 66 residents of all training levels at Northwell Health-Lenox Hill Hospital in New York City, NY, completed this session. Upon completion, participant performance of breast and pelvic exams improved at every step of each procedure. Additionally, participant comfort, confidence, and intent to perform breast and pelvic exams increased.
Given the success of this session, this educational experience was expanded to include modules on other key ambulatory procedures to promote the development of independent, competent, proficient, and professional IM practitioners who provide high-quality, patient-centered care while fulfilling the program requirements set forth by the ACGME.
无论内科住院医师的职业规划如何，他们都必须能够执行一名合格内科医生所需的门诊操作。不幸的是，由于住院医师培训的大部分内容都集中在住院患者的经历上，许多内科住院医师可能在门诊环境和门诊操作中感到不自在。
此处描述的课程是一个为时1.5小时、以病例为基础的互动模块，面向所有培训水平的住院医师，围绕关键的门诊操作展开，由经验丰富的教员在逼真的全身人体模型患者护理模拟器上演示上述操作，随后由该教员直接观察住院医师的操作能力。每组四名学生最为理想。由于临床教育工作者担任主持人，教员培训仅限于对每个课程的简要介绍。与本出版物相关的材料包括课程方案、病例、直接观察程序检查表、参与前调查问卷和参与后调查问卷。
从2014年7月到2015年6月，纽约市诺斯韦尔健康-莱诺克斯山医院的66名所有培训水平的住院医师完成了该课程。课程结束后，参与者在乳房和盆腔检查每个步骤中的表现都有所提高。此外，参与者进行乳房和盆腔检查时的舒适度、信心以及意愿都有所增加。
鉴于该课程的成功，这一教育体验得以扩展，纳入了关于其他关键门诊操作的模块，以促进培养独立、胜任、熟练且专业的内科医生，他们在满足美国研究生医学教育认证委员会规定的项目要求的同时，提供高质量、以患者为中心的医疗服务。
