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为成年自闭症患者制定准备计划:一项由成年自闭症患者及其家庭成员参与设计的针对住院医师的成人自闭症培训。

Development of PREPARE for Autistic Adults: An Adult Autism Training for Resident Physicians Designed with Autistic Adults and Family Members.

作者信息

Hand Brittany N, Gilmore Daniel, DeVassie Holden, Longo Anne, Juckett Lisa, Hanks Christopher, Havercamp Susan M, Coury Daniel

机构信息

School of Health and Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio, USA.

Center for Autism Services and Transition, Columbus, Ohio, USA.

出版信息

Autism Adulthood. 2025 Feb 5;7(1):112-120. doi: 10.1089/aut.2023.0137. eCollection 2025 Feb.

Abstract

One barrier to meeting autistic adults' health care needs is the dearth of physicians with autism training. We developed an adult autism training for residents, who are postdoctoral physicians training to become specialists, in internal medicine or family medicine. We used formative evaluation to design the training with autistic adults and family members of autistic adults, who were paid consultants. The training includes six prerecorded presentations, six case studies, and two standardized patient scenarios. We conducted focus groups and interviews with 23 residents and 14 faculty who educate residents. We described the curriculum, reviewed the content in one module, and obtained feedback on maximizing feasibility and scalability. Using semantic-level inductive rapid qualitative analysis we identified three themes and two subthemes. First, "flexibility is key" described ways to increase flexibility to accommodate resident and faculty schedules across programs. Second, "time is the most valuable asset" described the need to minimize duration and maximize impact. Third, "buy-in is necessary" described ways to increase buy-in from residents and residency leadership. Two subthemes, "we don't talk much about neurodivergence" and "this content applies to all patients," describe how to increase buy-in by highlighting how this training fills a gap in resident education and can be generalized to multiple populations. Results highlighted ways to modify our training to maximize implementability across different residency programs. Next steps include pilot testing of feasibility, acceptability and effects on resident self-efficacy, attitudes/beliefs, and knowledge. In the long term, we expect this will yield more adult care physicians prepared to meet autistic adults' needs.

摘要

满足成年自闭症患者医疗保健需求的一个障碍是缺乏接受过自闭症培训的医生。我们为住院医师开发了一项成人自闭症培训项目,这些住院医师是正在接受内科或家庭医学专科培训的博士后医生。我们通过形成性评估,与成年自闭症患者及其家庭成员(他们是付费顾问)共同设计了该培训项目。培训内容包括六个预先录制的讲座、六个案例研究以及两个标准化患者场景。我们对23名住院医师和14名负责培训住院医师的教员进行了焦点小组访谈。我们描述了课程设置,审查了其中一个模块的内容,并就如何最大限度地提高可行性和可扩展性征求了反馈意见。通过语义层面的归纳式快速定性分析,我们确定了三个主题和两个子主题。首先,“灵活性是关键”描述了增加灵活性以适应不同项目中住院医师和教员日程安排的方法。其次,“时间是最宝贵的资产”描述了尽量缩短培训时长并最大化培训效果的必要性。第三,“获得认可很有必要”描述了提高住院医师和住院医师培训项目领导层认可程度的方法。两个子主题,“我们对神经多样性讨论得不多”和“这些内容适用于所有患者”,描述了如何通过强调该培训如何填补住院医师教育中的空白以及如何推广到多种人群来提高认可度。研究结果突出了修改我们的培训项目以在不同住院医师培训项目中最大限度提高可实施性的方法。下一步包括对可行性、可接受性以及对住院医师自我效能、态度/信念和知识的影响进行试点测试。从长远来看,我们预计这将培养出更多有能力满足成年自闭症患者需求的成人护理医生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5543/11937756/120066e8826b/aut.2023.0137_figure1.jpg

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