Rope Robert, Merrell Sylvia Bereknyei, Stedman Margaret, Young Brian
Oregon Health and Science University Division of Nephrology and Hypertension.
Stanford University School of Medicine Division of General Medical Disciplines.
MedEdPublish (2016). 2017 Sep 4;6:153. doi: 10.15694/mep.2017.000153. eCollection 2017.
This article was migrated. The article was marked as recommended. Education in consultation is a potentially valuable, but understudied, element of medical education. Inpatient consultation is an opportunity for significant subspecialist contact for resident trainees and an avenue for improving their knowledge and patient care across content areas. We evaluated the perceived educational effectiveness of education in consultation among internal medicine residents, within a university and a community-based program, as well as the role of barriers in medical training that may limit education. We used a web-based survey expanded from a previously published survey consisting of 12 questions, including one free-response, on education in consultation. Data were analyzed descriptively and qualitatively. We surveyed residents from two internal medicine programs in 2016. One within a large university-based hospital and the second within a smaller community-based safety-net hospital. 91/198 (46%) of residents responded. Overall results from both programs were similar despite their structural differences. Residents viewed education in consultation as a priority and the majority felt it was at least moderately effective but underutilized. Importantly, educational interactions are largely dependent on outreach from residents. While in-person teaching interactions were the most effective, key barriers to these interactions include a lack of time, difficulty locating residents, and the perception of residents as being too busy. Inpatient consultation offers a unique opportunity for specialist-led education for internal medicine residents. It is potentially effective but constrained extensively in modern training environments. Interventions aimed at emphasizing education in consultation within fellowships and residencies, increasing in-person resident-specialist interactions, and addressing structural barriers, may improve resident knowledge across specialties and strengthen patient care.
本文已迁移。该文章被标记为推荐文章。会诊教育是医学教育中一个潜在有价值但研究不足的要素。住院会诊是住院医师学员与专科医生进行重要接触的机会，也是提高他们在各个领域知识和患者护理水平的途径。我们评估了在内科住院医师中，在大学和社区项目中会诊教育的感知教育效果，以及医学培训中可能限制教育的障碍的作用。我们使用了一项基于网络的调查，该调查是在之前发表的一项调查基础上扩展而来的，该调查由12个问题组成，包括一个关于会诊教育的自由回答问题。对数据进行了描述性和定性分析。我们在2016年对两个内科项目的住院医师进行了调查。一个在大型大学附属医院，另一个在较小的社区安全网医院。198名居民中有91名（46%）做出了回应。尽管两个项目结构不同，但总体结果相似。住院医师将会诊教育视为优先事项，大多数人认为它至少有一定效果，但未得到充分利用。重要的是，教育互动在很大程度上依赖于住院医师的主动参与。虽然面对面的教学互动最有效，但这些互动的关键障碍包括时间不足、难以找到住院医师以及认为住院医师太忙。住院会诊为内科住院医师提供了由专科医生主导教育的独特机会。它可能有效，但在现代培训环境中受到很大限制。旨在强调在专科培训和住院医师培训中进行会诊教育、增加住院医师与专科医生的面对面互动以及解决结构性障碍的干预措施，可能会提高住院医师在各个专科的知识水平并加强患者护理。
