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未来的医生是否了解以患者为中心的护理:对 16 所医学院校课程的内容分析。

Unclear if future physicians are learning about patient-centred care: Content analysis of curriculum at 16 medical schools.

机构信息

Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.

出版信息

Med Teach. 2021 Sep;43(9):1085-1091. doi: 10.1080/0142159X.2021.1918332. Epub 2021 Apr 29.

DOI:10.1080/0142159X.2021.1918332
PMID:33915064
Abstract

PURPOSE

Given barriers of patient-centred care (PCC) among physicians and trainees, this study assessed how medical schools addressed PCC in curriculum.

METHOD

The authors used content analysis to describe PCC in publicly-available curriculum documents of Canadian medical schools guided by McCormack's PCC Framework, and reported results using summary statistics and text examples.

RESULTS

The authors retrieved 1459 documents from 16 medical schools (median 49.5, range 16-301). Few mentioned PCC (301, 21.2%), and even fewer thoroughly or accurately described PCC. Significantly more clerkship versus pre-clerkship (24.0% vs 12.6%,  < 0.00001), and elective compared with core course descriptions (24.7% vs 14.9%,  < 0.00001) mentioned PCC. The domain of foster a healing relationship was common (79.0%) compared with other domains: address concerns (16.5%), exchange information (14.9%), enable self-care (10.4%), share decisions (4.5%), and manage uncertainty (1.3%).

CONCLUSIONS

Overall, few documents mentioned or described PCC or related concepts. This varied by school, and was more frequent in clerkship and elective courses, suggesting that student exposure may be brief and variable. Thus, it remains unclear if medical students are fully exposed to what PCC means and how to implement it. Future research is needed to confirm if PCC content in medical curriculum is lacking.

摘要

目的

鉴于医生和受训者在以患者为中心的护理(PCC)方面存在障碍,本研究评估了医学院校在课程中如何解决 PCC 问题。

方法

作者使用内容分析法,根据 McCormack 的 PCC 框架,描述了加拿大医学院校公开课程文件中的 PCC,并使用摘要统计数据和文本示例报告结果。

结果

作者从 16 所医学院中检索到 1459 份文件(中位数为 49.5,范围为 16-301)。只有很少的文件提到了 PCC(301 份,21.2%),并且更少的文件能全面或准确地描述 PCC。实习课程比预科课程(24.0%比 12.6%,<0.00001),以及选修课程比核心课程(24.7%比 14.9%,<0.00001)更常提到 PCC。培养良好关系的领域更为常见(79.0%),而其他领域包括:解决问题(16.5%)、交流信息(14.9%)、促进自我护理(10.4%)、共同决策(4.5%)和管理不确定性(1.3%)。

结论

总体而言,很少有文件提到或描述 PCC 或相关概念。这因学校而异,在实习和选修课程中更为常见,这表明学生的接触可能是短暂和多变的。因此,目前尚不清楚医学生是否完全了解 PCC 的含义以及如何实施它。需要进一步研究以确认医学课程中是否缺乏 PCC 内容。

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