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通过卫生政策增强内科住院医师能力:一种激发并教导行动的简单方法。

Empowering Internal Medicine Residents Through Health Policy: A Simple Approach to Inspire and Teach Action.

作者信息

Reister Robin, Altillo Brandon

机构信息

Internal Medicine, Dell Medical School, Austin, USA.

出版信息

Cureus. 2024 Sep 11;16(9):e69198. doi: 10.7759/cureus.69198. eCollection 2024 Sep.

Abstract

Background Most physicians receive little or no teaching about health policy during residency, despite accreditation organizations emphasizing the need to do so. Lack of time, expert faculty, and institutional financial support can be barriers to implementing a health policy experience. Aim Our goal was to educate internal medicine residents about the legislative process, improve their ability to engage with lawmakers and inspire them to effect policy change in their role as physicians. We aimed to impart a basic knowledge of how health policy decisions are made and give residents hands-on experience in speaking to lawmakers without requiring significant faculty or resident time.  Settings Residents attended an hour-long classroom presentation at our medical school. A portion of them attended a lobby day with the Texas Medical Association (TMA). This consisted of introductory training at the TMA building and then a meeting with individual legislators at the Capitol.  Participants Sixty-three internal medicine residents received the classroom presentation. Thirteen residents attended the lobby day, ten of whom were in the primary care track, and three were residents in the categorical program who expressed interest and had scheduled availability. Three Dell Medical School faculty members also attended the lobby day. Program description Residents attended a one-hour classroom presentation about the legislative process, current health policy proposals, and local organizations and their policy priorities. Residents then participated in a lobby day with the Texas Medical Association (TMA) in the spring of 2023, which consisted of an introductory session with an issue briefing and training sessions. Residents were then separated into groups based on their zip code, guided in how to speak on behalf of their experiences, and met with their local lawmakers. Program evaluation We administered a pre- and post-experience survey. Only 16.7% had ever met with a lawmaker, but they highly rated the importance of engaging in health policy (mean±SD, 4.42±0.79). The experience significantly increased from pre- to post-experience their ability to contact their lawmaker (2.75 to 3.89), confidence in their ability to discuss policy with a lawmaker (2.33 to 3.56), and their sense of empowerment that they have a voice that can influence policy (2.92 to 4.22). Discussion Internal medicine residents view engagement with health policy as an important experience during training. By utilizing existing resources in our institution combined with an existing lobbying opportunity, we were able to improve resident confidence and abilities to engage in policymaking without substantial financial or time costs.

摘要

背景

尽管认证机构强调有必要在住院医师培训期间教授健康政策相关内容,但大多数医生在培训期间很少或根本没有接受过这方面的教学。时间不足、缺乏专家教员以及机构资金支持可能成为实施健康政策体验的障碍。

目的

我们的目标是对内科住院医师进行立法程序教育,提高他们与立法者接触的能力,并激励他们以医生的身份推动政策变革。我们旨在传授健康政策决策是如何制定的基础知识,并让住院医师在与立法者交谈方面获得实践经验,而无需教员或住院医师投入大量时间。

设置

住院医师在我们医学院参加了一场为时一小时的课堂讲座。他们中的一部分人参加了与德克萨斯州医学协会(TMA)共同举办的游说日活动。该活动包括在TMA大楼进行的入门培训,然后在州议会大厦与个别立法者会面。

参与者

63名内科住院医师参加了课堂讲座。13名住院医师参加了游说日活动,其中10名是初级保健方向的住院医师,3名是分类项目中的住院医师,他们表示有兴趣且有时间安排。三名戴尔医学院的教员也参加了游说日活动。

项目描述

住院医师参加了一场为时一小时的课堂讲座,内容涉及立法程序、当前的健康政策提案以及当地组织及其政策重点。然后,住院医师在2023年春季与德克萨斯州医学协会(TMA)共同参加了游说日活动,活动包括一场有问题简报的入门会议和培训课程。住院医师随后根据他们的邮政编码分组,学习如何代表自己的经历发言,并与当地立法者会面。

项目评估

我们进行了体验前和体验后的调查。只有16.7%的人曾与立法者会面,但他们对参与健康政策的重要性给予了高度评价(均值±标准差,4.42±0.79)。从体验前到体验后,他们与立法者联系的能力(从2.75提高到3.89)、与立法者讨论政策的信心(从2.33提高到3.56)以及他们认为自己有能够影响政策的发言权的赋权感(从2.92提高到4.22)都有显著提高。

讨论

内科住院医师认为参与健康政策是培训期间的一项重要经历。通过利用我们机构的现有资源并结合现有的游说机会,我们能够在不产生大量财务或时间成本的情况下,提高住院医师参与政策制定的信心和能力。

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