Geiger W J, Neuberger M J, Bell G C
Toledo Hospital Family Practice Residency Program, OH.
Fam Med. 1993 Jul-Aug;25(7):447-51.
Despite growing emphasis on preventive services, physicians still provide low levels of these services to their patients. Barriers to providing preventive services might be modified by more effective teaching models at the residency level. The purpose of this study was to evaluate a practice-based teaching model designed to increase resident compliance with the US Preventive Services Task Force Guidelines.
In Phase One of this study, physicians received didactic education about the US Preventive Services Task Force Guidelines. Subsequently, physicians' compliance with these recommendations was monitored. During Phase Two of the study, a comprehensive two-visit "Health Check" appointment was instituted. It incorporated a computerized health risk appraisal that was reviewed with patients. After the Health Check program was implemented, physicians' compliance with the guidelines was again audited.
The chart audits revealed an overall increase in the level of preventive services provided by physicians from 31% in Phase One to 74% in Phase Two (P < .01).
This type of teaching model can effectively increase the level of preventive services provided to patients in a family practice residency.
尽管对预防服务的重视程度不断提高，但医生向患者提供的此类服务水平仍然较低。住院医师培训阶段更有效的教学模式可能会改变提供预防服务的障碍。本研究的目的是评估一种基于实践的教学模式，旨在提高住院医师对美国预防服务工作组指南的依从性。
在本研究的第一阶段，医生接受了关于美国预防服务工作组指南的理论教育。随后，监测医生对这些建议的依从性。在研究的第二阶段，设立了一次全面的、分两次就诊的“健康检查”预约。它纳入了一项与患者一起审查的计算机化健康风险评估。在实施健康检查计划后，再次审核医生对指南的依从性。
图表审核显示，医生提供的预防服务水平总体上从第一阶段的31%提高到了第二阶段的74%（P < .01）。
这种教学模式可以有效地提高家庭医学住院医师培训中向患者提供的预防服务水平。
