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ADEPT-CARE:一项试点项目,由学生主导,旨在通过一种新颖的教学工具改善残疾人士的护理。

ADEPT-CARE: A pilot, student-led initiative to improve care for persons with disabilities via a novel teaching tool.

机构信息

Penn State College of Medicine, 700 HMC Cres Road, Hershey, 17033, PA, USA.

Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, 02215, MA, USA.

出版信息

Disabil Health J. 2023 Jul;16(3):101462. doi: 10.1016/j.dhjo.2023.101462. Epub 2023 Mar 24.

Abstract

BACKGROUND

Over one-quarter of United States adults live with a disability. Despite persistent ableism, defined as discrimination and prejudice against people with disabilities, in healthcare, disability-focused training remains largely absent from medical education.

OBJECTIVE

The aim of this study was to pilot and evaluate a novel teaching mnemonic (ADEPT-CARE) for performing a comprehensive history and physical exam for disabled patients.

METHODS

In Spring 2022, first-year medical students at a suburban Mid-Atlantic institution could electively participate in a learning module that included ADEPT-CARE. Surveys were administered to students before and following exposure to the ADEPT-CARE protocol.

RESULTS

Of 142 eligible students, 33 and 21 completed the pre- and post-surveys, respectively. The ADEPT-CARE protocol made sense to 95.2% of students. All (100%) students reported that they will use the ADEPT-CARE protocol in the assessment of patients with disabilities. Students were more likely to agree or strongly agree that they had a consistent approach or strategy in mind when assessing a patient with a disability after exposure to ADEPT-CARE (85.7% vs. 39.4%, respectively, p = 0.002). There was no statistically significant difference in students' perceived confidence in their ability to assess a patient with a disability after curriculum completion compared to before (85.7% vs. 81.8%, respectively, p = 1.0).

CONCLUSIONS

The ADEPT-CARE protocol has the potential to be an effective teaching tool by providing a framework to equitably care for disabled patients. Future research should assess whether students' self-reported increased confidence and intention to utilize ADEPT-CARE translates into the clinical setting.

摘要

背景

超过四分之一的美国成年人患有残疾。尽管在医疗保健中存在持续的能力歧视,即对残疾人士的歧视和偏见,但以残疾为重点的培训在医学教育中仍然基本缺失。

目的

本研究旨在试点和评估一种用于为残疾患者进行全面病史和体格检查的新型教学记忆技巧(ADEPT-CARE)。

方法

2022 年春季,位于大西洋中部郊区的一所机构的一年级医学生可以选修一个包含 ADEPT-CARE 的学习模块。在接触 ADEPT-CARE 方案前后,向学生发放调查问卷。

结果

在 142 名符合条件的学生中,分别有 33 名和 21 名学生完成了预调查和后调查。95.2%的学生认为 ADEPT-CARE 方案有意义。所有(100%)学生表示他们将在评估残疾患者时使用 ADEPT-CARE 方案。接触 ADEPT-CARE 后,学生更有可能同意或强烈同意他们在评估残疾患者时有一个一致的方法或策略(分别为 85.7%和 39.4%,p=0.002)。与课程完成前相比,学生在完成课程后对评估残疾患者的能力的自我感知信心没有统计学上的显著差异(分别为 85.7%和 81.8%,p=1.0)。

结论

ADEPT-CARE 方案有可能成为一种有效的教学工具,为公平地照顾残疾患者提供框架。未来的研究应评估学生自我报告的信心增加和使用 ADEPT-CARE 的意愿是否转化为临床环境。

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The State of Disability Awareness in American Medical Schools.美国医学院校的残疾认知状况
Am J Phys Med Rehabil. 2017 Sep;96(9):673-676. doi: 10.1097/PHM.0000000000000719.
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Persons with disabilities as an unrecognized health disparity population.残疾人作为一个未被认识到的健康差异人群。
Am J Public Health. 2015 Apr;105 Suppl 2(Suppl 2):S198-206. doi: 10.2105/AJPH.2014.302182. Epub 2015 Feb 17.
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