神经病学住院医师健康公平课程的可行性与有效性评估

Feasibility and effectiveness appraisal of a neurology residency health equities curriculum.

作者信息

Mendizabal Adys, Fan Jessica H, Price Raymond S, Hamilton Roy H

机构信息

Department of Neurology, University of California-Los Angeles, Los Angeles, CA, USA.

Department of Neurology, University of California-San Francisco, San Francisco, CA, USA.

出版信息

J Neurol Sci. 2021 Dec 15;431:120040. doi: 10.1016/j.jns.2021.120040. Epub 2021 Oct 22.

DOI:10.1016/j.jns.2021.120040

PMID:34748973

Abstract

BACKGROUND

Despite increasing awareness of inequities in healthcare in neurology, health equity is not a core competency of neurology training. To meet this need, we implemented a health equities curriculum for neurology residents at the Hospital of the University of Pennsylvania.

METHODS

A seven-lecture health equities curriculum was implemented during the 2019-2020 academic year. Surveys were distributed pre-and post-curriculum to assess resident demographics, previous training in health equities, curriculum effectiveness addressing health equities topics, and resident appraisal of the curriculum.

RESULTS

On average, residents attended 2-3 lectures. Most of the residents who participated were White-Non Latinx women. Residents who did not participate in the curriculum listed clinical responsibilities as the main reason for absenteeism. Residents who participated felt the curriculum was at least somewhat effective in addressing health disparities, cultural competency, and implicit bias. 64% of the residents felt the curriculum was effective in improving their preparedness in caring for underserved patients.

CONCLUSION

Implementing a health equities curriculum in neurology residency programs is feasible and well-received by residents. Given inconsistent attendance and a small sample size, we are unable to assess its true effectiveness. Nonetheless, residents felt it prepared them in addressing disparities in neurological care. A longer curriculum will help in assessing the effectiveness of this curriculum intervention. A standard health equities curriculum should be implemented across neurology residency programs, and health equities should be considered a core competency topic for the American Board of Psychiatry and Neurology (ABPN) certification.

摘要

背景

尽管人们对神经病学医疗保健中的不公平现象的认识不断提高，但健康公平并非神经病学培训的核心能力。为满足这一需求，我们在宾夕法尼亚大学医院为神经病学住院医师实施了一项健康公平课程。

方法

在2019 - 2020学年实施了为期七讲的健康公平课程。在课程前后分发调查问卷，以评估住院医师的人口统计学特征、先前在健康公平方面的培训、课程在解决健康公平主题方面的有效性以及住院医师对课程的评价。

结果

住院医师平均参加了2 - 3次讲座。参与的住院医师大多是白人非拉丁裔女性。未参加课程的住院医师将临床职责列为缺勤的主要原因。参与课程的住院医师认为该课程在解决健康差异、文化能力和隐性偏见方面至少有一定效果。64%的住院医师认为该课程有效地提高了他们照顾服务不足患者的准备程度。

结论

在神经病学住院医师培训项目中实施健康公平课程是可行的，并且受到住院医师的欢迎。鉴于参与人数不一致且样本量较小，我们无法评估其真正效果。尽管如此，住院医师认为该课程帮助他们应对神经病学护理中的差异。更长的课程将有助于评估这一课程干预的效果。应在所有神经病学住院医师培训项目中实施标准的健康公平课程，并且健康公平应被视为美国精神病学和神经病学委员会（ABPN）认证的核心能力主题。