Kratzke Ian M, Portelli Tremont Jaclyn N, Marulanda Kathleen, Carter Taylor M, Reid Trista D, Perez Arielle J, Kapadia Muneera R
From the Department of Surgery, University of North Carolina, Chapel Hill, NC.
J Am Coll Surg. 2022 Feb 1;234(2):182-188. doi: 10.1097/XCS.0000000000000041.
Healthcare disparities are an important determinant of patient outcomes yet are not standardized within surgical resident education. This study aimed to determine the prevalence and design of current healthcare disparities curricula for surgical residents and included a resident-based needs assessment at a single institution.
A national survey evaluating the presence and design of healthcare disparities curricula was distributed to general surgery program directors via the Association of Program Directors in Surgery Listserv. A related survey was administered to all general surgery residents at a single academic institution.
One hundred forty-six program directors completed the survey, with 68 (47%) reporting an active curriculum. The most frequently taught topic is regarding patient race as a healthcare disparity, found in 63 (93%) of existing curricula. Fifty-two (76%) of the curricula were implemented within the last 3 years. Of the 78 (53%) programs without a curriculum, 8 (10%) program directors stated that their program would not benefit from one. Thirty-four (45%) of the programs without a curriculum cited institutional support and time as the most common barriers to implementation. Of the 23 residents who completed the survey, 100% desired learning practical knowledge regarding healthcare disparities relating to how race and socioeconomic status affect the clinical outcomes of surgical patients.
Less than half of general surgery training programs have implemented healthcare disparities curricula. Resident preferences for the format and content of curricula may help inform program leaders and lead to comprehensive national standards.
医疗保健差异是患者治疗结果的一个重要决定因素，但在外科住院医师教育中尚未标准化。本研究旨在确定当前外科住院医师医疗保健差异课程的普及率和设计情况，并在单一机构进行了基于住院医师的需求评估。
通过外科项目主任协会邮件列表向普通外科项目主任分发了一项评估医疗保健差异课程的存在和设计情况的全国性调查。在一个学术机构对所有普通外科住院医师进行了相关调查。
146名项目主任完成了调查，其中68名（47%）报告有现行课程。最常讲授的主题是将患者种族视为医疗保健差异，在63项（93%）现有课程中都有涉及。52项（76%）课程是在过去3年内实施的。在78项（53%）没有课程的项目中，8名（10%）项目主任表示他们的项目不会从课程中受益。34项（45%）没有课程的项目将机构支持和时间列为实施的最常见障碍。在完成调查的23名住院医师中，100%希望学习关于医疗保健差异的实用知识，涉及种族和社会经济地位如何影响外科患者的临床结果。
不到一半的普通外科培训项目实施了医疗保健差异课程。住院医师对课程形式和内容的偏好可能有助于为项目负责人提供信息，并促成全面的国家标准。
