Heglund Leonardo Garcia, Jaradeh Katrin, Ornelas-Dorian Carolina, Stark Nicholas, Cheng Theresa, Peabody Christopher R
University of California, San Francisco, Department of Emergency Medicine, San Francisco, California.
Dignity Health - Mercy Medical Center, Department of Emergency Medicine, Merced, California.
West J Emerg Med. 2025 Jul 12;26(4):781-785. doi: 10.5811/westjem.33576.
As of 2021, there were 47 million immigrants in the United States. Immigrant populations are uninsured at higher rates than US citizens, leading many to rely on emergency departments (ED) for their healthcare needs. However, emergency physicians (EP) often lack training on the unique challenges faced by this population, necessitating educational interventions.
We implemented educational interventions for an urban emergency medicine residency program using Kern's six-step approach for curriculum development to inform EPs of existing immigration-specific patient resources; teach social-medical-legal best practices with regard to asking, documenting, and sharing immigration-specific health information; and increase awareness of ED-relevant local policies. We developed three educational interventions.in collaboration with legal organizations, and community experts. To evaluate the success of these interventions we administered a pre- and post-survey to 64 EPs (36% of 178 targeted learners) RESULTS: We found a significant increase in confidence and knowledge, with an average 5-point Likert scale score improvement of 1.47 (P < .001) in all responses and 1.40 (P < .001) in paired responses, and an improvement in test scores on the three knowledge-based questions of 30.66% (P < .001) in all responses and 33% (P = .02) in paired responses.
This study highlights a model for interprofessional collaboration in curriculum development and the importance of a multipronged educational approach to improve the care of immigrants in the ED. The curriculum offers a framework for other EDs aiming to address healthcare inequities for this population. Future research can explore long-term knowledge retention, detailed educational tool utilization, and the impact on patients.
截至2021年,美国有4700万移民。移民群体未参保的比例高于美国公民,这使得许多人依赖急诊科来满足其医疗需求。然而,急诊医生往往缺乏应对该群体所面临独特挑战的培训,因此需要进行教育干预。
我们采用克恩课程开发六步法,对一个城市急诊医学住院医师项目实施教育干预,以使急诊医生了解现有的针对移民患者的资源;教授询问、记录和分享特定移民健康信息方面的社会 - 医学 - 法律最佳实践;并提高对与急诊科相关的当地政策的认识。我们与法律组织和社区专家合作开发了三项教育干预措施。为评估这些干预措施的成效,我们对64名急诊医生(占178名目标学习者的36%)进行了前后调查。结果:我们发现信心和知识有显著提高,所有回答的平均李克特量表得分提高了1.47(P < .001),配对回答提高了1.40(P < .001),所有回答中基于知识的三个问题的测试成绩提高了30.66%(P < .001),配对回答提高了33%(P = .02)。
本研究突出了课程开发中跨专业合作的模式以及多管齐下的教育方法对于改善急诊科中移民患者护理的重要性。该课程为其他旨在解决该群体医疗保健不平等问题的急诊科提供了一个框架。未来的研究可以探索长期知识保留、详细教育工具的使用以及对患者的影响。