解决高血压方面的健康差异：一项针对医学生和专业人员的综合医学选修课程及调查研究
Addressing Health Disparities in Hypertension: A Comprehensive Medical Elective and Survey Study Among Medical Students and Professionals.
作者信息
Richardson J D, Kline H L, Ko B Y, Hooper A, Komanapalli S, Alvarez-Del-Pino J D, Yeh E S
机构信息
Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202 USA.
Indiana University School of Medicine, Indianapolis, IN 46202 USA.
出版信息
Med Sci Educ. 2024 Jun 25;34(5):1107-1115. doi: 10.1007/s40670-024-02099-5. eCollection 2024 Oct.
INTRODUCTION
Medical education utilizes standard clinical practice and recommends clinical algorithms to inform trainee curricula. The use of race and ethnicity as a medical screening tool impacts medical outcomes by associating race with genetics without considering that race incorporates social, economic, and cultural variables that influence outcomes.
METHODS
To evaluate underlying factors contributing to differences in hypertension prevalence, control, and treatment recommendations across race/ethnicities, a 2-week elective course was developed for third- and fourth-year medical students. In this elective course, students performed self-directed literature-based research on hypertension health disparities. We then developed three videos that addressed the racial/ethnic impact on hypertension prevalence and control and incorporated the students' research findings. The videos were presented at a lunch-and-learn session, open to medical students and health professionals, that was focused on healthcare inequities in hypertension. Pre- and post-session survey data was collected to assess how the discussion changed participant knowledge and impressions of the role race plays in hypertension prevalence, control, and treatment.
RESULTS
Survey results denoted that 100% of lunch-and-learn participants increased their understanding of the impact of health inequities on hypertension. Overall, there were significant differences in knowledge gained and understanding of health disparities that influence hypertension treatment across participants from all genders and racial or ethnic groups. Notably, pre-session survey results indicated that participants tended to agree that treatment guidelines incorporating race improve equity in the treatment of hypertension whereas post-session results showed that participants were less likely to agree with this assertion.
CONCLUSIONS
Developing educational opportunities to discuss health inequities can influence perceptions of patient care.
引言
医学教育采用标准临床实践并推荐临床算法以指导实习医生课程。将种族和族裔用作医学筛查工具会通过将种族与遗传学联系起来影响医疗结果，而未考虑到种族包含影响结果的社会、经济和文化变量。
方法
为评估导致不同种族/族裔间高血压患病率、控制率及治疗建议存在差异的潜在因素，为三、四年级医学生开发了一门为期两周的选修课程。在这门选修课程中，学生针对高血压健康差异进行自主文献研究。随后，我们制作了三段视频，探讨种族/族裔对高血压患病率和控制的影响，并纳入了学生的研究结果。这些视频在一个面向医学生和健康专业人员的午餐学习会上播放，该会议聚焦于高血压方面的医疗保健不平等问题。会前和会后收集了调查数据，以评估讨论如何改变参与者对种族在高血压患病率、控制和治疗中所起作用的认识和印象。
结果
调查结果表明，100%的午餐学习会参与者增进了对健康不平等对高血压影响的理解。总体而言，所有性别以及种族或族裔群体的参与者在获得的知识以及对影响高血压治疗的健康差异的理解方面存在显著差异。值得注意的是，会前调查结果表明参与者倾向于认同纳入种族因素的治疗指南可改善高血压治疗的公平性，而会后结果显示参与者不太可能认同这一观点。
结论
开展讨论健康不平等问题的教育机会能够影响对患者护理的认知。
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