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实习医生准备从事老年精神病学临床工作的情况:对 18 项初步可委托专业活动的调查。

Trainee doctors' preparedness for clinical work in geriatric psychiatry: A survey on 18 preliminary entrustable professional activities.

机构信息

University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.

Institute of Medical Psychology, Heidelberg University Hospital, Ruprecht-Karls University Heidelberg, Heidelberg, Germany.

出版信息

Int J Geriatr Psychiatry. 2023 Jun;38(6):e5954. doi: 10.1002/gps.5954.

Abstract

BACKGROUND

Research concerning transitions from one rotation to another during medical specialist training is scarce. This study examined trainee doctors' perceived preparedness for core clinical activities, trainee doctors' preparedness levels, and general perceptions of medical specialist training in geriatric psychiatry.

METHOD

Swiss trainee doctors in geriatric psychiatry were surveyed about their perceived preparedness for 18 preliminary entrustable professional activities (EPAs), curricular support, and general perceptions of their medical specialist training. Closed questions were analysed using descriptive statistics, while open questions were subjected to content analysis.

RESULTS

The participants comprised 48 trainee doctors (30.4% response rate) who differed in their educational experience (years of residency and specialism) and clinical subspecialisation goals. Trainee doctors felt adequately prepared for most EPAs but less prepared for some, including electroconvulsive therapy, psychotherapy, and treating older adults in the home environment or residential facilities. Despite the trainee doctors' diversity, they did not differ significantly in perceived preparedness for most EPAs. The most often offered suggestions for improving geriatric psychiatry training were intensified clinical supervision and a structured induction programme.

CONCLUSION

Trainee doctors reported that they felt sufficiently prepared for most EPAs, regardless of their backgrounds and professional goals. However, several professional activities in geriatric psychiatry warrant further training. Our findings indicate the need for a higher intensity of clinical supervision (e.g. more direct observation and specific feedback), the introduction of structured induction programmes (e.g. orientation week), and specific teachings (e.g. on neurocognitive assessment).

摘要

背景

关于医学专科培训中从一个轮转过渡到另一个轮转的研究很少。本研究考察了受训医生对核心临床活动的感知准备情况、受训医生的准备水平以及对老年精神病学专科培训的总体看法。

方法

对瑞士老年精神病学的受训医生进行了调查,了解他们对 18 项初步可委托专业活动(EPA)、课程支持以及对其专科培训的总体看法的感知准备情况。使用描述性统计分析封闭问题,而对开放问题进行内容分析。

结果

参与者包括 48 名受训医生(30.4%的回应率),他们在教育经验(住院年限和专业)和临床亚专业目标方面存在差异。受训医生对大多数 EPA 感到有足够的准备,但对一些 EPA 准备不足,包括电休克疗法、心理治疗以及在家庭环境或住宿设施中治疗老年人。尽管受训医生存在多样性,但他们对大多数 EPA 的感知准备情况没有显著差异。最常提出的改善老年精神病学培训的建议是加强临床监督和结构化的入职计划。

结论

无论背景和职业目标如何,受训医生报告称他们对大多数 EPA 感到有足够的准备。然而,老年精神病学中的一些专业活动需要进一步培训。我们的研究结果表明需要更高强度的临床监督(例如更多的直接观察和具体反馈)、引入结构化的入职计划(例如入职周)以及特定的教学(例如神经认知评估)。

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