Department of Emergency Medicine, STRATUS Center for Medical Simulation, Brigham and Women's Hospital, Harvard Medical School, Harvard Humanitarian Initiative, Boston, Massachusetts, USA.
Harvard Affiliated Emergency Medicine Resident, Massachusetts General and Brigham and Women's Hospitals, Boston, Massachusetts, USA.
Med Educ. 2022 Aug;56(8):793-804. doi: 10.1111/medu.14808. Epub 2022 Apr 25.
War negatively impacts health professional education when health care is needed most. The aims of this scoping review are to describe the scope of barriers and targeted interventions to maintaining health professional education during war and summarise the research.
We conducted a scoping review between 20 June 2018 and 2 August 2018. The search was restricted to English publications including peer-reviewed publications without date ranges involving war and health professional education (medical school, residency training and nursing school), with interventions described to maintain educational activities. Two independent reviewers completed inclusion determinations and data abstraction. Thematic coding was performed using an inductive approach allowing dominant themes to emerge. The frequency of barrier and intervention themes and illustrative quotes were extracted. Articles were divided into modern/postmodern categories to permit temporal and historical analysis of thematic differences.
Screening identified 3271 articles, with 56 studies meeting inclusion criteria. Publication dates ranged from 1914-2018 with 17 unique wars involving 17 countries. The studies concerned medical students (61.4%), residents (28.6%) and nursing students (10%). Half involved the modern era and half the postmodern era. Thematic coding identified five categories of barriers and targeted interventions in maintaining health professions education during war: curriculum, personnel, wellness, resources, and oversight, with most involving curriculum and personnel. The distribution of themes among various health professional trainees was similar. The frequency and specifics changed temporally reflecting innovations in medical education and war, with increased focus on oversight and personnel during the modern era and greater emphasis on wellness, curriculum, and resources during the postmodern era.
There are overarching categories of barriers and targeted interventions in maintaining health professional education during war which evolve over time. These may serve as a useful framework to strategically support future research and policy efforts.
当最需要医疗保健时，战争会对卫生专业人员的教育产生负面影响。本范围综述的目的是描述在战争期间维持卫生专业教育的障碍范围和针对性干预措施，并总结研究结果。
我们于 2018 年 6 月 20 日至 8 月 2 日进行了范围综述。搜索仅限于英语出版物，包括没有日期范围的同行评议出版物，涉及战争和卫生专业教育（医学院、住院医师培训和护理学校），并描述了维持教育活动的干预措施。两名独立的审查员完成了纳入标准的确定和数据提取。使用归纳方法进行主题编码，允许出现主导主题。提取了障碍和干预主题以及说明性引语的频率。文章分为现代/后现代类别，以允许对主题差异进行时间和历史分析。
筛选出 3271 篇文章，其中 56 篇研究符合纳入标准。出版日期从 1914 年至 2018 年不等，涉及 17 个国家的 17 场独特战争。这些研究涉及医学生（61.4%）、住院医师（28.6%）和护理学生（10%）。其中一半涉及现代时期，一半涉及后现代时期。主题编码确定了在战争期间维持卫生职业教育的五类障碍和针对性干预措施：课程、人员、健康、资源和监督，其中大多数涉及课程和人员。各种卫生专业学员之间的主题分布相似。随着医学教育和战争的创新，频率和具体情况发生了变化，在现代时期更加注重监督和人员，在后现代时期更加注重健康、课程和资源。
在战争期间维持卫生专业教育存在普遍的障碍和针对性干预措施，这些措施随着时间的推移而演变。这些措施可以作为支持未来研究和政策努力的有用框架。
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