Wollstadt L J
J Fam Pract. 1979 Jan;8(1):107-12.
Student-physicians saw patients from assigned families at primary care training sites either one or two half-days a week. These practice conditions caused a skewing of diagnoses away from seeing acute conditions. Students who saw patients two half-days a week made 21 percent fewer acute care diagnoses than were made in the practice. Those students at the clinical site one half-day a week saw 28 percent fewer acute disease diagnoses. Accordingly, there was an increase in the percentage of chronic disease and health supervision diagnoses in the case mix of these student-physicians. This part-time scheduling of students at the training sites was related to a disruption in continuity of care for the patient. While a little less than half of acute illness care was performed by student-physicians, over two thirds of chronic disease diagnoses were made by these once-or-twice-a-week trainees. Almost nine tenths of health care supervision was accomplished within the trainees' twice-a-week schedule.
医学生在初级保健培训点为指定家庭的患者看病，每周一或两个半天。这些实习条件导致诊断结果偏向于不看急性病。每周看两个半天患者的学生做出的急性护理诊断比实际应有的少21%。那些每周在临床实习点看一个半天的学生做出的急性病诊断少28%。因此，这些医学生的病例组合中慢性病和健康监督诊断的比例有所增加。在培训点对学生进行的这种兼职安排与患者护理连续性的中断有关。虽然急性病护理略少于一半是由医学生进行的，但超过三分之二的慢性病诊断是由这些每周来一两次的实习生做出的。几乎十分之九的医疗监督是在实习生每周两次的日程安排内完成的。
