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从主任视角看家庭医学团队会议的质量:一项自我民族志研究。

The Quality of Family Medicine Team Conferences Through the Lens of a Director: An Autoethnography.

作者信息

Ohta Ryuichi, Sano Chiaki

机构信息

Community Care, Unnan City Hospital, Unnan, JPN.

Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN.

出版信息

Cureus. 2024 Jul 9;16(7):e64173. doi: 10.7759/cureus.64173. eCollection 2024 Jul.

Abstract

Introduction In rural medical settings, team conferences are essential for effective patient care, especially given the challenges of limited resources and personnel. These conferences promote collaborative discussions on patient management and serve as vital educational sessions. This study explores the dynamics and efficacy of team conferences in the family medicine department of a rural hospital to optimize patient care and educational outcomes. Methods This qualitative study used autoethnography at Unnan City Hospital, Unnan, Japan. Data collection included semi-structured interviews, direct observation, reflective field notes, and informal conversations with medical students, junior residents, and general medicine trainees. The focus was on conference interactions, educational content, and operational challenges. Data analysis involved coding and theming, with ongoing discussions among researchers and participants to refine findings. Results Three key themes emerged. First, patient outcomes suffered from a lack of professional awareness. Second, mutual understanding and individual autonomy enhanced team quality. Third, team healthcare quality improved through diverse and inclusive learning experiences. Effective facilitation, structured time management, and integrating practical bedside learning with theoretical discussions were crucial for optimizing team conferences. Psychological safety, respect for individual differences, and maintaining motivation were essential for productive team interactions. Conclusion The study highlights the importance of effective facilitation, time management, and integrating practical and theoretical learning in enhancing team conferences in rural medical settings. Psychological safety and mutual respect are vital for fostering a collaborative and motivated team environment. Addressing these factors can improve patient care and educational experiences. Future research should include diverse settings and quantitative measures to validate and refine these insights, enhancing team conferences in rural healthcare environments.

摘要

引言 在农村医疗环境中,团队会议对于有效的患者护理至关重要,特别是考虑到资源和人员有限的挑战。这些会议促进了关于患者管理的协作讨论,并作为重要的教育环节。本研究探讨了农村医院家庭医学科团队会议的动态和效果,以优化患者护理和教育成果。

方法 本定性研究在日本云南市立医院采用了自我民族志方法。数据收集包括半结构化访谈、直接观察、反思性实地笔记以及与医学生、初级住院医师和普通内科实习生的非正式交谈。重点是会议互动、教育内容和操作挑战。数据分析涉及编码和主题提炼,研究人员和参与者持续进行讨论以完善研究结果。

结果 出现了三个关键主题。第一,患者结果因缺乏专业意识而受到影响。第二,相互理解和个人自主性提高了团队质量。第三,通过多样化和包容性的学习经历提高了团队医疗质量。有效的引导、结构化的时间管理以及将床边实践学习与理论讨论相结合对于优化团队会议至关重要。心理安全、尊重个体差异和保持积极性对于富有成效的团队互动至关重要。

结论 该研究强调了有效引导、时间管理以及将实践和理论学习相结合在加强农村医疗环境中团队会议方面的重要性。心理安全和相互尊重对于营造协作和积极的团队环境至关重要。解决这些因素可以改善患者护理和教育体验。未来的研究应包括不同的环境和定量措施,以验证和完善这些见解,加强农村医疗环境中的团队会议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b09b/11309739/837c80d742a6/cureus-0016-00000064173-i01.jpg

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