MD Program, University of Toronto, 27 King's College Cir, Toronto, ON, M5S 3H7, Canada.
The Wilson Centre for Research in Education, Faculty of Medicine, University of Toronto, University Health Network, 200 Elizabeth Street, 1ES-565, Toronto, ON, M5G 2C4, Canada.
BMC Med Educ. 2019 Aug 28;19(1):322. doi: 10.1186/s12909-019-1758-9.
Given the increasing evidence and expansion of integrated care (IC) in healthcare, new IC curricula introduced early in undergraduate medical education (UME) are needed. Building on a pilot IC simulation called "Getting to Know Patients' System of Care" (GPS-Care), we aimed to explore students' understanding of patients' complex physical and mental health needs, and to increase our understanding of how students learned in this simulation.
177 of 259 first-year medical students participated in GPS-Care at the University of Toronto. Students role-played an elderly patient or caregiver within 5 simulated healthcare professional appointments. Students completed written reflections and 7 students participated in one-on-one interviews. A thematic analysis of the reflections and transcripts was conducted and descriptive data was generated for questionnaires.
Data saturation was reached at 43 reflections and 7 transcripts and the following themes emerged: a) students reflected on patients' complex care experiences, b) students reflected on of the healthcare system needs care, c) students increased understanding of IC, and d) students desire to improve the care of IC patients within the healthcare system.
In addition to confirming previous pilot study themes, the results from this study identified the role of productive struggle to provide students with a deeper understanding of patients' IC care needs. Moreover, GPS-Care resulted in a transformative learning experience resulting in new insights into the importance of IC early in UME training.
鉴于综合医疗保健（IC）的证据不断增加和范围不断扩大，需要在本科医学教育（UME）早期引入新的 IC 课程。在名为“了解患者护理系统”（GPS-Care）的 IC 模拟试验的基础上，我们旨在探讨学生对患者复杂身心需求的理解，并增进我们对学生在这种模拟中学习方式的理解。
多伦多大学的 259 名一年级医学生中有 177 名参加了 GPS-Care。学生在 5 次模拟医疗保健专业预约中扮演老年患者或护理人员。学生完成书面反思，7 名学生参加了一对一访谈。对反思和转录本进行了主题分析，并为问卷生成了描述性数据。
43 份反思和 7 份转录本达到了数据饱和，出现了以下主题：a）学生反思了患者复杂的护理经验，b）学生反思了医疗保健系统需要护理，c）学生增加了对 IC 的理解，以及 d）学生希望改善医疗保健系统中 IC 患者的护理。
除了证实先前的试点研究主题外，这项研究的结果还确定了富有成效的斗争的作用，为学生提供了对患者 IC 护理需求的更深入理解。此外，GPS-Care 带来了变革性的学习体验，使人们对 UME 培训早期 IC 的重要性有了新的认识。
