Hendricson W D, Wood P R, Hidalgo H A, Kromer M E, Parcel G S, Ramirez A G
Division of Instructional Development, University of Texas Health Science Center-San Antonio.
Arch Pediatr Adolesc Med. 1994 Jun;148(6):595-601. doi: 10.1001/archpedi.1994.02170060049008.
To increase pediatric residents' knowledge of the Guidelines for the Diagnosis and Management of Asthma (GDMA) developed by the Expert Panel of the National Asthma Education Program and to increase the residents' confidence in their ability to implement these guidelines. Emphasis was placed on the diagnosis and treatment of Hispanic children with asthma, a population at increased risk for morbidity.
A continuity care clinic located in an urban ambulatory care facility.
Forty-four pediatric residents: 17 first-year residents, 15 second-year residents, and 12 third-year residents.
Residents participated in a multicomponent asthma management curriculum that stressed active learning strategies, including the following: focus groups, computer-based testing, lectures, hands-on skill development seminars, role modeling by attending pediatricians, provision of GDMA pocket cards and posters, access to peak flowmeters and spirometry, and an interactive computer-based module. Content focused on pulmonary function testing with spirometry and peak flowmeters, stepwise use of medications, recognition of asthma symptoms and triggers, and cultural considerations that impact asthma management. Pediatric faculty and fellows also participated in a series of asthma seminars to increase the likelihood that faculty would role model the GDMA and provide appropriate feedback to residents.
Pediatric residents demonstrated significant increases in knowledge about evaluation of asthma, pulmonary function testing, and clinical management, displayed significantly enhanced levels of confidence, and were enthusiastic about the asthma management curriculum, rating it significantly higher than 15 other content areas in the general pediatric curriculum.
增加儿科住院医师对国家哮喘教育项目专家小组制定的《哮喘诊断和管理指南》（GDMA）的了解，并增强他们实施这些指南的信心。重点关注哮喘发病率较高的西班牙裔儿童的诊断和治疗。
位于城市门诊护理机构的连续性护理诊所。
44名儿科住院医师，其中17名一年级住院医师、15名二年级住院医师和12名三年级住院医师。
住院医师参与了一个多组件哮喘管理课程，该课程强调主动学习策略，包括：焦点小组、基于计算机的测试、讲座、实践技能发展研讨会、儿科主治医生的示范、提供GDMA袖珍卡片和海报、使用峰值流量计和肺功能仪，以及一个基于计算机的交互式模块。内容聚焦于使用肺功能仪和峰值流量计进行肺功能测试、逐步用药、识别哮喘症状和诱因，以及影响哮喘管理的文化因素。儿科教员和研究员也参加了一系列哮喘研讨会，以增加教员示范GDMA并为住院医师提供适当反馈的可能性。
儿科住院医师在哮喘评估、肺功能测试和临床管理方面的知识有显著增加，信心水平显著提高，并且对哮喘管理课程充满热情，对其评分显著高于普通儿科课程中的其他15个内容领域。
