Simpson C A
Can J Neurol Sci. 1977 Nov;4(4):265-8. doi: 10.1017/s0317167100025099.
A study of 200 patients referred to a community neurologist showed that 87.5% of the patients were seen in the office and only 12.5% in hospital. Neurological signs were present in 52% and 28.5% had neurological signs which materially affected the diagnosis. A questionnaire sent to several teaching centers showed that only one center sent students and residents to community neurologists' offices at all and in most centers the resident spent just 10 to 20% of his time seeing out-patients. It was felt that the balance of in-patient/out-patient teaching for students and residents was wrong, and that more emphasis should be placed on the neurological history than on the examination. Proposals are made to involve the community neurologist as well as the academic neurologist in the training of students and residents which would benefit all four groups.
一项针对200名转诊至社区神经科医生处的患者的研究表明，87.5%的患者在诊所就诊，仅12.5%的患者住院。52%的患者存在神经体征，28.5%的患者的神经体征对诊断有重大影响。一份发给多个教学中心的调查问卷显示，只有一个中心会派学生和住院医师到社区神经科医生的诊所，在大多数中心，住院医师仅花费10%至20%的时间诊治门诊患者。人们认为，学生和住院医师的住院/门诊教学平衡有误，而且应更加强调神经病史而非体格检查。建议让社区神经科医生和学术神经科医生都参与到学生和住院医师的培训中，这将使所有四个群体都受益。
