A.S. Beard is medicine clerkship director, Veterans Affairs Longitudinal Undergraduate Medical Education (VALUE) program, section chief, Division of Hospital Medicine, Minneapolis VA Health Care System, and assistant professor of medicine, University of Minnesota Medical School, Minneapolis, Minnesota; ORCID: https://orcid.org/0000-0002-3258-5248. A.E. Candy is former clerkship co-director, Veterans Affairs Longitudinal Undergraduate Medical Education (VALUE) program, Minneapolis VA Health Care System, and assistant professor of medicine, University of Minnesota Medical School, Minneapolis, Minnesota. T.J. Anderson is an internal medicine resident, Gunderson Lutheran Medical Center, La Crosse, Wisconsin. N.P. Derrico is a neurosurgery resident, University of Mississippi Medical Center, Jackson, Mississippi. K.A. Ishani is an undergraduate (Baccalaureate) student, Yale University, New Haven, Connecticut. A.A. Gravely is a statistician, Research Service, Minneapolis VA Health Care System, Minneapolis, Minnesota. R. Englander is associate dean, Undergraduate Medical Education, University of Minnesota Medical School, Minneapolis, Minnesota. N.G. Ercan-Fang is associate director, Medical Education for Primary and Specialty Care Services, clerkship co-director, Veterans Affairs Longitudinal Undergraduate Medical Education (VALUE) program, staff endocrinologist, Minneapolis VA Health Care System, and associate professor of medicine, University of Minnesota Medical School, Minneapolis, Minnesota; ORCID: https://orcid.org/0000-0002-5338-9027.
Acad Med. 2020 Mar;95(3):417-424. doi: 10.1097/ACM.0000000000003021.
To determine whether longitudinal student involvement improves patient satisfaction with care.
The authors conducted a satisfaction survey of patients followed by 10 University of Minnesota Medical School students enrolled in 2016-2017 in the Veterans Affairs Longitudinal Undergraduate Medical Education (VALUE) program, a longitudinal integrated clerkship at the Minneapolis Veterans Health Care System. Students were embedded in an ambulatory practice with primary preceptors who assigned students a panel of 14 to 32 patients to follow longitudinally in inpatient and outpatient settings. Control patients, matched on disease severity, were chosen from the preceptor's panel. Two to five months after the students completed the VALUE program, the authors conducted a phone survey of the VALUE and control patients using a validated, customized questionnaire.
Results are reported from 97 VALUE patients (63% response rate) and 72 controls (47% response rate) who had similar baseline characteristics. Compared with control patients, VALUE patients reported greater satisfaction with explanations provided by their health care provider, their provider's knowledge of their personal history, and their provider's looking out for their best interests (P < .05). Patients in the VALUE panel selected the top category more often than control patients for overall satisfaction with their health care (65% vs 43%, P < .05).
The results of this controlled trial demonstrate that VALUE student longitudinal participation in patient care improves patient satisfaction and patient-perceived quality of health care for VALUE patients compared with controls matched by primary care provider and disease severity. These findings may have implications outside the Veterans Administration population.
确定学生的纵向参与是否能提高患者对护理的满意度。
作者对在明尼苏达大学医学院学习的 10 名学生进行了一项满意度调查，这些学生于 2016 年至 2017 年期间参加了退伍军人事务部纵向本科医学教育（VALUE）项目，该项目是明尼苏达退伍军人医疗保健系统的一个纵向综合实习项目。学生与主要导师一起在门诊实践中，导师为他们分配了 14 至 32 名患者进行纵向随访，包括住院和门诊患者。从导师的患者名单中选择对照组患者。在学生完成 VALUE 项目后的 2 至 5 个月，作者使用经过验证的定制问卷对 VALUE 组和对照组患者进行了电话调查。
报告了 97 名 VALUE 患者（63%的回复率）和 72 名对照组患者（47%的回复率）的结果，他们具有相似的基线特征。与对照组患者相比，VALUE 组患者报告说，他们的医疗服务提供者提供的解释、提供者对其个人病史的了解程度以及提供者为他们的最佳利益着想的情况，他们更满意（P<0.05）。VALUE 组患者更经常选择顶级类别，对他们的整体医疗满意度（65%对 43%，P<0.05）。
这项对照试验的结果表明，与通过初级保健提供者和疾病严重程度匹配的对照组相比，VALUE 学生纵向参与患者护理可以提高患者满意度和患者对医疗服务质量的感知。这些发现可能对退伍军人事务部以外的人群有影响。
