Gelb D J
Department of Neurology, University of Michigan, Ann Arbor.
Arch Neurol. 1994 Aug;51(8):817-20. doi: 10.1001/archneur.1994.00540200097022.
To determine how residency programs are responding to the shift of neurological practice into the outpatient setting.
A nine-item questionnaire was sent to the directors of all US neurology residency programs. Each item had two parts, the first describing the current program, and the second describing an "ideal" program designed to optimize resident education. The same questionnaire was also sent to all house officers and faculty associated with a single residency program to assess variability in perceptions.
United States neurology residency programs (mail survey).
Directors of neurology residency programs and all house officers and faculty members at a single residency program.
Eighty-one (70%) of the 116 questionnaires distributed were returned. There were four areas of general consensus among the program directors: (1) more time should be devoted to outpatient care during residency training; (2) more continuity at the resident level should be provided for patients seen in subspecialty clinics; (3) faculty should provide more supervision of residents when they see follow-up patients; and (4) conferences specifically directed at outpatient management issues should be developed.
Neurology residency directors agree that current approaches to teaching in the outpatient setting fall short of an educationally ideal system. Four areas of perceived deficiency have been identified. Creative solutions will be necessary to correct these perceived deficiencies.
确定住院医师培训项目如何应对神经科医疗实践向门诊环境的转变。
向美国所有神经科住院医师培训项目的主任发送了一份包含九个条目的问卷。每个条目有两部分,第一部分描述当前项目,第二部分描述旨在优化住院医师教育的“理想”项目。同样的问卷也发送给了与一个住院医师培训项目相关的所有住院医师和教员,以评估认知上的差异。
美国神经科住院医师培训项目(邮寄调查)。
神经科住院医师培训项目的主任以及一个住院医师培训项目的所有住院医师和教员。
分发的116份问卷中有81份(70%)被收回。项目主任们普遍达成共识的有四个方面:(1)住院医师培训期间应增加门诊护理的时间;(2)在专科门诊就诊的患者在住院医师层面应提供更多连续性服务;(3)教员在住院医师诊治随访患者时应提供更多监督;(4)应开展专门针对门诊管理问题的会议。
神经科住院医师培训项目主任们一致认为,目前门诊环境下的教学方法达不到教育理想体系的要求。已确定了四个被认为存在不足的方面。需要创造性的解决方案来纠正这些被认为的不足。