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家庭医学住院医师培训项目中满足儿童照护培训要求的挑战:一项 CERA 研究。

Challenges Meeting Training Requirements in the Care of Children in Family Medicine Residency Programs: A CERA Study.

机构信息

Herman and Walter Samuelson Children's Hospital at Sinai, Baltimore, MD.

Mount Sinai Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY.

出版信息

Fam Med. 2023 Apr;55(4):238-244. doi: 10.22454/FamMed.2023.761754. Epub 2023 Feb 13.

Abstract

BACKGROUND AND OBJECTIVE

In 2014, the Accreditation Council for Graduate Medical Education (ACGME) implemented numeric requirements for family medicine (FM) pediatric patient encounters. Impact on residency programs is unclear. We aimed to identify any difficulties faced by FM program directors (PDs) meeting these numeric requirements.

METHODS

Questions about pediatric training in family medicine residencies were included in a survey of PDs conducted by the Council of Academic Family Medicine Educational Research Alliance (CERA). We performed univariate analysis of the demographic and program characteristics. We then used χ2 tests of independence to test for bivariate associations between these characteristics and our primary outcome: the most difficult ACGME pediatric care requirement to meet.

RESULTS

Most programs reported the hospital as the primary location of training (n=131, 46%) and their family medicine practice (FMP) patient population consisted of over 20% pediatric patients (n=153, 56%). Over 80% of program directors reported challenges meeting FM requirements for the care of children. Challenges meeting pediatric requirements were associated with fewer than 20% FMP patients under 19 years of age (P<.0001), fewer than 50% of core FM faculty caring for sick children (P=.0128), and primary location of pediatric training in a family health center (P=.0006).

CONCLUSION

Difficulty meeting ACGME requirements for the care of children in FM residency programs is common, especially for programs with fewer than 20% FMP patients under 19 years of age. Further research is needed to determine how best to assure FM resident competencies in the care of children and adolescents.

摘要

背景与目的

2014 年,美国毕业后医学教育认证委员会(ACGME)对家庭医学(FM)儿科患者就诊次数提出了数值要求。但目前尚不清楚这对住院医师培训计划有何影响。我们旨在确定家庭医学项目主任(PD)在满足这些数值要求时所面临的任何困难。

方法

学术家庭医学教育研究联盟理事会(CERA)对 PD 进行的调查中包含了有关家庭医学住院医师儿科培训的问题。我们对人口统计学和项目特征进行了单变量分析。然后,我们使用 χ2 独立性检验来检验这些特征与我们的主要结果(最难满足的 ACGME 儿科护理要求)之间的双变量关联。

结果

大多数项目报告医院是培训的主要地点(n=131,46%),其家庭医学实践(FMP)患者人群中有超过 20%的儿科患者(n=153,56%)。超过 80%的项目主任报告在满足 FM 对儿童护理的要求方面存在挑战。满足儿科要求的挑战与 FMP 患者中 19 岁以下的患者少于 20%(P<.0001)、不到 50%的核心 FM 教员照顾生病的儿童(P=.0128)以及儿科培训的主要地点在家庭健康中心(P=.0006)有关。

结论

在 FM 住院医师培训计划中,满足 ACGME 对儿童护理的要求具有一定难度,尤其是对于 FMP 患者中 19 岁以下的患者少于 20%的计划。需要进一步研究以确定如何最好地确保 FM 住院医师在儿童和青少年护理方面的能力。

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