Gennis V M, Gennis M A
Division of General Internal Medicine, University of Wisconsin Medical School, Milwaukee.
J Gen Intern Med. 1993 Jul;8(7):378-80. doi: 10.1007/BF02600077.
Two levels of faculty supervision in a resident teaching clinic were compared. Attending physicians recorded their impressions of diagnoses, treatment, severity of illness, and resident performance from case presentation alone and again after personally evaluating the patient. After direct evaluation, the attendings judged patients to be more seriously ill and rated resident performance lower. Changes in diagnosis and management were frequent. The attendings considered seeing the patient in person valuable for teaching in 18% of the cases, and for management in 27% of the cases. Faculty-patient interaction doubled supervisory time. Outpatient teaching and patient management are significantly affected when faculty see patients in person.
对住院医师教学诊所中的两级教师监督进行了比较。主治医师仅根据病例陈述记录他们对诊断、治疗、疾病严重程度和住院医师表现的印象，在亲自评估患者后再次记录。直接评估后，主治医师判断患者病情更严重，并对住院医师表现的评分更低。诊断和管理方面的变化很频繁。主治医师认为亲自查看患者对18%的病例教学有价值，对27%的病例管理有价值。教师与患者的互动使监督时间增加了一倍。当教师亲自查看患者时，门诊教学和患者管理会受到显著影响。
