Cykert S, Flannery M T, Huber E C, Keyserling T, Moses G A, Elnicki D M, Hannis M
Internal Medicine Training Program, Moses H. Cone Memorial Hospital, Greensboro, North Carolina 27401, USA.
Am J Med Sci. 1997 Sep;314(3):198-202. doi: 10.1097/00000441-199709000-00009.
The objective of this study was to determine the need for telephone medicine curricula and to help define important content for internal medicine residencies using scales that measure program director attitudes toward telephone medicine. Data were collected by surveying all 416 program directors of accredited internal medicine residencies in the United States. We applied factor analysis to develop reliable attitudinal scales and employed regression models to identify predictors of these attitudes. Response rate was 60%. Formal training for telephone medicine was available in only 6% of programs. The factor analysis showed three attitudinal concepts; all described marked program director discomfort with aspects of resident telephone prescription. Predictors of improved program director comfort included more frequent documentation of resident telephone calls, chart availability, and clear definition of resident roles pertaining to telephone interactions with patients (P < 0.02 for all predictor variables). These results identify a need for telephone curricula and suggest components that might alleviate program director discomfort with resident telephone practices.
本研究的目的是确定电话医学课程的需求，并通过衡量项目主任对电话医学态度的量表，帮助界定内科住院医师培训的重要内容。通过对美国所有416名经认可的内科住院医师培训项目主任进行调查来收集数据。我们应用因子分析来开发可靠的态度量表，并使用回归模型来确定这些态度的预测因素。回复率为60%。只有6%的项目提供电话医学的正规培训。因子分析显示了三个态度概念；所有这些都表明项目主任对住院医师电话处方的各个方面存在明显的不满。项目主任舒适度提高的预测因素包括更频繁地记录住院医师的电话、病历可用性以及明确界定住院医师在与患者电话互动方面的角色（所有预测变量的P<0.02）。这些结果确定了对电话课程的需求，并提出了可能减轻项目主任对住院医师电话实践不满的组成部分。
