Lesser A L
Med Educ. 1981 Nov;15(6):398-406. doi: 10.1111/j.1365-2923.1981.tb02422.x.
A unique 8-year training programme for 110 family medicine residents is described. The psychiatrist works in a family medicine setting with the staff doctors, residents, and patients. The approach evolved because patients wanted a brief problem intervention, and because doctors wanted rapid and efficient methods to identify and treat problems, without using a psychodynamic model. For empirical data collection and clear problem description, a behavioural model is employed. For assessment and therapy, a problem-orientated approach is emphasized, which is rapidly acquired and effectively applied. 'Diagnoses' are not used unless relevant, and paradigms or methods of handling common patient problems are employed. The residents learn in groups and develop skills through supervision of actual patient encounters. There is a phase progression of skill acquisition which is reinforced by the staff doctors. Eighty-seven per cent of the residents achieve the required objectives, and can apply and utilize an approach geared to the needs and realities of everyday practice.
本文介绍了一项针对110名家庭医学住院医师的独特的八年培训计划。精神科医生与全科医生、住院医师和患者一起在家庭医学环境中工作。这种方法的演变是因为患者希望得到简短的问题干预，也因为医生希望找到快速有效的方法来识别和治疗问题，而不使用心理动力学模型。为了进行实证数据收集和清晰地描述问题，采用了行为模型。在评估和治疗方面，强调采用以问题为导向的方法，这种方法能够快速掌握并有效应用。除非相关，否则不使用“诊断”，而是采用处理常见患者问题的范例或方法。住院医师通过小组学习，并在实际患者诊疗过程的监督中培养技能。技能获取有一个阶段进展过程，并得到全科医生的强化。87%的住院医师达到了所需目标，并且能够应用和利用一种适合日常实践需求和实际情况的方法。
