Stanford University School of Medicine, Stanford, CA, USA.
J Prim Care Community Health. 2021 Jan-Dec;12:21501327211004285. doi: 10.1177/21501327211004285.
Medical assistants (MAs) were once limited to obtaining vital signs and office work. Now, MAs are foundational to team-based care, interacting with patients, systems, and teams in many ways. The transition to Virtual Health during the COVID-19 pandemic resulted in a further rapid and unique shift of MA roles and responsibilities. We sought to understand the impact of this shift and to place their new roles in the context of national professional competency standards.
In this qualitative, grounded theory study we conducted semi-structured interviews with 24 MAs at 10 primary care sites at a major academic medical center on their experiences during the shift from in-person to virtual care. MAs were selected by convenience sample. Coding was done in Dedoose version 8.335. Consensus-based inductive and deductive approaches were used for interview analysis. Identified MA roles were compared to national MA, Institute of Medicine, physician, and nursing professional competency domains.
Three main themes emerged: Role Apprehension, Role Expansion, and Adaptability/Professionalism. Nine key roles emerged in the context of virtual visits: direct patient care (pre-visit and physical care), panel management, health systems ambassador, care coordination, patient flow coordination, scribing, quality improvement, and technology support. While some prior MA roles were limited by the virtual care shift, the majority translated directly or expanded in virtual care. Identified roles aligned better with Institute of Medicine, physician, and nursing professional competencies, than current national MA curricula.
The transition to Virtual Health decreased MA's direct clinical work and expanded other roles within interprofessional care, notably quality improvement and technology support. Comparison of the current MA roles with national training program competencies identified new leadership and teamwork competencies which could be expanded during MA training to better support MA roles on inter-professional teams.
医疗助理(MAs)曾经仅限于获取生命体征和办公室工作。现在,MAs 是团队为基础的护理的基础,以多种方式与患者、系统和团队互动。在 COVID-19 大流行期间向虚拟健康的转变导致 MA 角色和职责的进一步快速和独特转变。我们试图了解这种转变的影响,并将他们的新角色置于国家专业能力标准的背景下。
在这项定性的扎根理论研究中,我们在一家主要学术医疗中心的 10 个初级保健站点对 24 名 MA 进行了半结构化访谈,了解他们在从面对面护理向虚拟护理转变期间的经历。MA 是通过方便样本选择的。在 Dedoose 版本 8.335 中进行编码。使用基于共识的归纳和演绎方法进行访谈分析。确定的 MA 角色与国家 MA、医学研究所、医生和护理专业能力领域进行了比较。
出现了三个主要主题:角色理解、角色扩展和适应性/专业精神。在虚拟访问的背景下出现了九个关键角色:直接患者护理(就诊前和身体护理)、面板管理、健康系统大使、护理协调、患者流程协调、抄写员、质量改进和技术支持。虽然一些之前的 MA 角色因虚拟护理转变而受到限制,但大多数角色在虚拟护理中直接或扩展。确定的角色与医学研究所、医生和护理专业人员的能力更一致,而不是当前的国家 MA 课程。
向虚拟健康的转变减少了 MA 的直接临床工作,并扩大了跨专业护理中的其他角色,特别是质量改进和技术支持。将当前的 MA 角色与国家培训计划的能力进行比较,确定了新的领导力和团队合作能力,这些能力可以在 MA 培训中扩展,以更好地支持 MA 在跨专业团队中的角色。