Caretta-Weyer Holly A, Hess Jamie M
Department of Emergency Medicine Stanford University School of Medicine Palo Alto California USA.
Department of Emergency Medicine University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
AEM Educ Train. 2022 Dec 8;6(6):e10820. doi: 10.1002/aet2.10820. eCollection 2022 Dec.
The increasing number of vulnerable populations served by the emergency department (ED) calls for developing and implementing curricula aimed at training residents to deliver quality care for the most marginalized groups.
We aimed to address this by developing and piloting a curriculum to introduce the unique challenges and disparities encountered by our diverse ED patient population using an experiential learning approach.
We engaged community partners in designing and implementing a curriculum for incoming interns. This curriculum addresses specific populations encountered within the ED including patients with psychiatric illness, patients with cognitive disabilities, intoxicated patients, violent patients, patients of various cultural backgrounds, non-English-speaking patients, and LGBTQ patients. Experiential and active learning sessions with content experts and site visits to area organizations were arranged. Pre-, post-, and time-delayed surveys were deployed to evaluate the pilot of this curriculum.
Thirteen incoming interns participated in the orientation curriculum. Residents' comfort with each of these various patient populations as well as familiarity with community and ED resources was assessed before, after, and 1 year delayed from each session (response 13/13, 100%). Their scores increased significantly from baseline in the postsurvey and were maintained 1 year later (p < 0.05). Residents additionally provided narrative responses regarding what they learned and what was most helpful after completing their intern year.
This pilot curriculum demonstrates that implementing an experiential learning curriculum and engaging community leaders and resources is key to training residents to address health disparities within their unique ED patient population. As such, it is imperative that we seek to immersively introduce trainees to the unique needs of the patient population they will serve early in training.
急诊科服务的弱势群体数量不断增加,这就需要开发并实施相关课程,旨在培训住院医师为最边缘化群体提供优质护理。
我们旨在通过开发并试行一门课程来解决这一问题,该课程采用体验式学习方法,介绍我们多样化的急诊科患者群体所面临的独特挑战和差异。
我们邀请社区合作伙伴参与设计并实施针对新入职实习生的课程。该课程涉及急诊科中遇到的特定人群,包括精神疾病患者、认知障碍患者、醉酒患者、暴力患者、不同文化背景的患者、非英语患者以及 LGBTQ 患者。安排了与内容专家的体验式和主动学习课程以及对当地组织的实地考察。部署了课前、课后和延时调查来评估该课程的试行情况。
13 名新入职实习生参加了入职培训课程。在每次课程之前、之后以及课程结束 1 年后,评估住院医师对这些不同患者群体的舒适度以及对社区和急诊科资源的熟悉程度(回复率 13/13,100%)。他们的分数在课后调查中较基线有显著提高,并在 1 年后保持(p < 0.05)。住院医师还提供了关于他们在完成实习年后所学内容以及最有帮助内容的叙述性回复。
这一试行课程表明,实施体验式学习课程并利用社区领袖和资源是培训住院医师解决其独特急诊科患者群体健康差异问题的关键。因此,我们必须在培训早期就让学员深入了解他们将服务的患者群体的独特需求。