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从虚拟和远程医疗跨专业教育诊所的开发与实施中汲取的经验教训。

Lessons Learned from the Development and Implementation of Virtual and Telehealth Interprofessional Educational Clinics.

作者信息

Leiman Erin R, Waite Kathleen A, Ostrovsky Daniel A

机构信息

Department of Surgery, Division of Emergency Medicine, Duke University School of Medicine, Durham, NC, USA.

Department of Medicine, Division of General Internal Medicine, Duke University School of Medicine, Durham, NC, USA.

出版信息

Adv Med Educ Pract. 2021 Oct 5;12:1145-1152. doi: 10.2147/AMEP.S328990. eCollection 2021.

Abstract

PURPOSE

The Interprofessional Educational (IPE) Clinic at Duke is a clinical experience that has allowed an interprofessional team, including health professions students, to care for patients in the emergency department (ED) since 2015. COVID-19 presented fundamental challenges to the structure of this experience, such as student restrictions on attending clinical experiences and limitations on the number of providers in a patient room, which necessitated a transition from face-to-face encounters to virtual ones.

MATERIALS AND METHODS

As a result, two virtual experiences were implemented; one was based in the ED with in-person faculty and patients with virtual learners and one staffed by ambulatory providers engaging in telehealth clinics. These experiences sought to provide an interprofessional clinical experience for students while following appropriate safety guidelines. Surveys were distributed to students post-clinic to gather student demographics and their feedback regarding the experience. Additionally, faculty preceptors provided insight into the experience, especially regarding logistics and infrastructure.

RESULTS

The virtual experiences successfully allowed teams of students to participate remotely in aspects of care including history taking, physical assessments, and medical decision-making. Additionally, the virtual care team structure allowed for senior students to mentor junior learners and for faculty members to provide point of care feedback. Students gained practical experience in telehealth that included logistics and challenges of providing virtual care and appreciating how technological barriers such as lack of access to internet-connected devices can be a source of disparity.

CONCLUSION

The COVID-19 pandemic required the reconfiguration of an in-person clinical experience to a virtual experience and this pivot was well received by students and faculty. The lessons learned can be generalizable to other professional schools who may be seeking to develop an interprofessional clinical experience and are exploring telehealth options.

摘要

目的

自2015年以来,杜克大学的跨专业教育(IPE)诊所是一种临床体验,它使包括健康专业学生在内的跨专业团队能够在急诊科(ED)为患者提供护理。2019冠状病毒病给这种体验的结构带来了根本性挑战,例如学生参加临床体验受到限制以及病房内医护人员数量受限,这使得必须从面对面接触转变为虚拟接触。

材料与方法

因此,实施了两种虚拟体验;一种是以急诊科为基础,由现场教员和虚拟学习者面对患者,另一种由门诊医护人员参与远程医疗诊所。这些体验旨在在遵循适当安全指南的同时,为学生提供跨专业临床体验。诊所结束后向学生发放了调查问卷,以收集学生的人口统计学信息及其对该体验的反馈。此外,教员导师对该体验提供了见解,特别是关于后勤和基础设施方面。

结果

虚拟体验成功地使学生团队能够远程参与护理的各个方面,包括病史采集、体格检查和医疗决策。此外,虚拟护理团队结构使高年级学生能够指导低年级学习者,教员能够提供即时护理反馈。学生在远程医疗方面获得了实践经验,包括提供虚拟护理的后勤和挑战,以及认识到诸如缺乏联网设备等技术障碍如何可能成为差异的一个来源。

结论

2019冠状病毒病大流行要求将面对面临床体验重新配置为虚拟体验,这种转变受到了学生和教员的好评。所吸取的经验教训可推广到其他可能寻求开展跨专业临床体验并正在探索远程医疗选项的专业学校。

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