S. Lin is clinical associate professor and executive director, Stanford Medical Scribe Fellowship, Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, California.
A. Duong is program manager, Stanford Medical Scribe Fellowship, Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Acad Med. 2021 May 1;96(5):671-679. doi: 10.1097/ACM.0000000000003757.
Professional burnout has reached epidemic levels among U.S. medical providers. One key driver is the burden of clinical documentation in the electronic health record, which has given rise to medical scribes. Despite the demonstrated benefits of scribes, many providers-especially those in academic health systems-have been unable to make an economic case for them. With the aim of creating a cost-effective scribe program in which premedical students gain skills that better position them for professional schooling, while providers at risk of burnout obtain documentation support, the authors launched the Clinical Observation and Medical Transcription (COMET) Program in June 2015 at Stanford University School of Medicine. COMET is a new type of postbaccalaureate premedical program that combines an apprenticeship-like scribing experience and a package of teaching, advising, application support, and mentored scholarship that is supported by student tuition. Driven by strong demand from both participants and faculty, the program grew rapidly during its first 5 years (2015-2020). Program evaluations indicated high levels of satisfaction among participants and faculty with their mentors and mentees, respectively; that participants felt the experience better positioned them for professional schooling; and that faculty reported improved joy of practice. In summary, tuition-supported medical scribe programs, like COMET, appear to be feasible and cost-effective. The COMET model may have the potential to help shape future health professions students, while simultaneously combating provider burnout. While scalability and generalizability remain uncertain, this model may be worth exploring at other institutions.
美国医疗服务提供者的职业倦怠已达到流行水平。一个关键的驱动因素是电子健康记录中的临床文档记录负担,这催生了医疗抄写员。尽管抄写员的益处已得到证明,但许多提供者——尤其是在学术医疗系统中的提供者——仍无法为其创造经济效益。为了创建一个具有成本效益的抄写员计划,使医预学生获得更好地为专业学业做准备的技能,同时为有职业倦怠风险的提供者提供文件支持,作者于 2015 年 6 月在斯坦福大学医学院启动了临床观察和医学转录(COMET)计划。COMET 是一种新型的本科后医学预科项目,它结合了类似学徒的抄写经验和一整套教学、咨询、申请支持和导师奖学金,由学生学费提供支持。在参与者和教师的强烈需求推动下,该计划在其成立的前 5 年(2015-2020 年)迅速发展。项目评估表明,参与者和教师分别对他们的导师和学员感到非常满意;参与者认为这种经历使他们更适合接受专业教育;教师报告称实践的乐趣有所提高。总之,学费支持的医疗抄写员计划,如 COMET,似乎是可行且具有成本效益的。COMET 模式有可能帮助塑造未来的卫生专业学生,同时应对提供者的职业倦怠。虽然可扩展性和普遍性仍不确定,但这种模式可能值得在其他机构进行探索。