Department of Family and Community Medicine, University of Cincinnati, Cincinnati, Ohio.
The Christ Hospital/University of Cincinnati Family Medicine Residency, Cincinnati, Ohio.
J Am Geriatr Soc. 2020 Apr;68(4):852-858. doi: 10.1111/jgs.16390. Epub 2020 Feb 27.
To develop a competency-based, adaptable home visit curricula and clinical framework for family medicine (FM) residents, and to examine resident attitudes, self-efficacy, and skills following implementation.
Quantitative analysis of resident survey responses and qualitative thematic analysis of written resident reflections.
Urban FM residency program.
A total of 43 residents and 20 homebound patients in a home-based primary care program.
A home-based primary care practice and accompanying curriculum for FM residents was developed and implemented to improve learners' confidence and skills to perform home visits.
A 10-question survey with a 4-point Likert scale and open-ended responses. Written resident reflections following home visits.
Over 3 years, 43 unique respondents completed a total of 79 surveys evaluating attitudes, skills, and barriers to home care. Some residents may have completed the survey more than once at different stages in their training. Overall, 86% are interested in home visits in future practice, and 78% of survey responses indicated an increased likelihood to perform home visits with more training. Learners with two or more home visits reported significantly improved confidence. Themes across all resident reflections included social determinants of health, patient-physician relationship, patient-home assessment, patient autonomy/independence, and physician wellness/attitudes. Residents described how home visits encourage more holistic care to improve outcomes for patients who are homebound.
Our home visit curriculum provided new learning, an enhanced desire to practice home-based primary care, improved learner confidence, and could help residents meet the need of a growing population of adults who are homebound. J Am Geriatr Soc 68:852-858, 2020.
为家庭医学（FM）住院医师开发基于能力的、适应性强的家访课程和临床框架，并考察实施后的住院医师态度、自我效能感和技能。
对住院医师调查回复的定量分析和对住院医师书面反思的定性主题分析。
城市 FM 住院医师项目。
参加家庭为基础的初级保健项目的共 43 名住院医师和 20 名居家患者。
为 FM 住院医师开发并实施了基于家庭的初级保健实践和配套课程，以提高学习者对执行家访的信心和技能。
包含 10 个问题的调查，采用 4 点李克特量表和开放式回答。家访后住院医师的书面反思。
在 3 年多的时间里，43 名独特的受访者共完成了 79 份评估态度、技能和家庭护理障碍的调查问卷。一些住院医师可能在不同的培训阶段多次完成了这项调查。总体而言，86%的人对未来实践中的家访感兴趣，78%的调查回复表明，随着更多的培训，他们更有可能进行家访。进行过两次或更多家访的学习者报告说信心明显增强。所有住院医师反思的主题都包括健康的社会决定因素、医患关系、患者-家庭评估、患者自主/独立性以及医生的健康/态度。住院医师描述了家访如何鼓励更全面的护理，以改善那些居家的患者的预后。
我们的家访课程提供了新的学习机会，增强了住院医师进行家庭为基础的初级保健实践的愿望，提高了学习者的信心，并有助于住院医师满足越来越多居家成年人的需求。美国老年医学会杂志 68:852-858, 2020。
