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Residents as Teachers: Benefits of Creating Infographics 居民即教师制作信息图表的好处
Pub Date : 2024-02-19 DOI: 10.22454/primer.2024.403662
Christopher M. Haymaker, Kirsten A. Porter-Stransky, Adam Channell
Introduction: While family medicine (FM) residents are expected to develop teaching skills during their residency, they often develop their approach to teaching informally, with limited explicit instruction in best teaching practices for patients or near peers. Infographics have become an increasingly common tool for teaching because of their ease of use and consistency of message. We explored the impact of an infographic assignment on residents’ teaching practices and perceptions of teaching. Methods: First- and second-year residents were assigned to create infographics on a topic of their choice. We transcribed and analyzed interviews using applied thematic analysis. Results: Residents indicated that the assignment helped them to integrate medical knowledge, identify pertinent points, and intentionally consider how they present information.Conclusion: Creating infographics is a useful way to develop residents’ teaching skills within the context of patient care. For most residents, explicit discussion of their approach to teaching was a new experience, suggesting that more frequent and explicit reflection on teaching could benefit residents, patients, and FM residency programs. 
导言:虽然全科医学住院医师在住院医师培训期间要培养教学技能,但他们往往只是非正式地培养自己的教学方法,而针对患者或邻近同行的最佳教学实践方面的明确指导却很有限。信息图表因其易用性和信息的一致性,已成为越来越常见的教学工具。我们探讨了信息图表作业对住院医师教学实践和教学观念的影响。方法:一年级和二年级住院医师被指派就自己选择的主题制作信息图表。我们采用应用主题分析法对访谈进行了记录和分析。结果住院医师表示,这项任务有助于他们整合医学知识、确定相关要点,并有意识地考虑如何呈现信息:结论:制作信息图表是培养住院医师在患者护理方面的教学技能的有效方法。对于大多数住院医师来说,明确讨论他们的教学方法是一种全新的体验,这表明更频繁、更明确地反思教学可使住院医师、患者和调频住院医师培训项目受益。
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引用次数: 0
Screening for Food Insecurity: A Curriculum for Medical Students 食品不安全筛查:医学生课程
Pub Date : 2024-02-19 DOI: 10.22454/primer.2024.858771
Y. Jarris, Heidi Chang, Sarah Kureshi, R. Mishori, Linda Kaljee, John Hunting, May-Lorie Saint Laurent, H. C. Chen
Introduction: Food insecurity (FI) is defined as a lack of access to enough food for an active, healthy life. We sought to determine how a longitudinal FI screening curriculum impacts medical students’ knowledge, attitudes, and behavior in screening for FI.Methods: This was a prospective, single-institution study. The curriculum consisted of three components completed over 3 years. We administered a survey to the intervention cohort before and after the curriculum and analyzed their written reflections. We also evaluated whether students screened for FI during an objective structured clinical exam (OSCE) and compared their performance to a control cohort, which did not receive the curriculum.Results: Preintervention, students felt screening for FI was important for physicians to do with their patients, but most felt uncomfortable addressing it in clinical settings. Postintervention, there was a statistically significant increase in mean scores for knowledge questions (45.24% vs 74.74%, P<.001, pre- and postintervention, respectively). Students also felt more confident in their abilities to screen and follow up about FI. Additionally, compared to the control cohort, the intervention cohort screened for FI more often during their OSCE (28.21% vs 10.71%, P<.001).Conclusion: A longitudinal curriculum using minimal curricular time can improve students’ knowledge, attitudes, and behavior when screening for FI. Students who received the curriculum were more likely to recognize the need for and perform FI screening. Based on these findings, we anticipate that the curriculum will increase the likelihood of students identifying, screening for, and intervening in cases of FI in future clinical encounters.
导言:粮食不安全(FI)被定义为缺乏足够的食物来维持积极健康的生活。我们试图确定纵向食物不安全筛查课程如何影响医学生筛查食物不安全的知识、态度和行为:这是一项前瞻性的单机构研究。该课程由三个部分组成,历时三年。我们在课程前后对干预人群进行了调查,并分析了他们的书面反思。我们还评估了学生在客观结构化临床考试(OSCE)中是否筛查出 FI,并将他们的成绩与未接受该课程的对照组进行了比较:结果:干预前,学生们认为对病人进行 FI 筛查对医生来说很重要,但大多数学生认为在临床环境中处理这一问题很不自在。干预后,知识问题的平均得分有了显著提高(干预前和干预后分别为 45.24% 和 74.74%,P<.001)。学生们对自己筛查和跟进 FI 的能力也更有信心。此外,与对照组相比,干预组在 OSCE 中筛查 FI 的频率更高(28.21% vs 10.71%,P<.001):纵向课程利用最少的课程时间就能提高学生在筛查 FI 时的知识、态度和行为。接受该课程的学生更有可能认识到进行 FI 筛查的必要性,并愿意进行筛查。基于这些研究结果,我们预计该课程将提高学生在未来临床工作中识别、筛查和干预 FI 病例的可能性。
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引用次数: 0
The Hazards of Using ChatGPT: Additional Comments 使用 ChatGPT 的危害:补充评论
Pub Date : 2024-02-19 DOI: 10.22454/primer.2024.203721
Amnugy Kleebayoon, V. Wiwanitkit
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引用次数: 0
Where Is mHealth in Integrated Primary Care Education? 移动医疗在综合初级保健教育中的地位如何?
Pub Date : 2024-02-14 DOI: 10.22454/primer.2024.566626
David J. Johnson
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引用次数: 0
Where Is mHealth in Integrated Primary Care Education? 移动医疗在综合初级保健教育中的地位如何?
Pub Date : 2024-02-14 DOI: 10.22454/primer.2024.566626
David J. Johnson
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引用次数: 0
Writing for Personal and Professional Wellness 为个人和职业健康写作
Pub Date : 2024-02-07 DOI: 10.22454/primer.2024.663516
José E. Rodríguez, Amy Locke, Kendall M. Campbell
Writing is a part of every academic career in medicine, yet many busy clinicians have difficulty finding time to write and may see it as extra work during their time off. This professional development perspective offers a reframing of writing, not as extra work, but as a wellness activity. The National Academy of Medicine’s (NAM) National Plan for Health Workforce Well-being identified seven priority areas where action should be taken to increase wellness in the workforce. Professional writing can “support mental health and reduce stigma” (an explicit NAM priority area) by allowing workers to express gratitude, practice reflection, and write without a deadline. Writing also addresses the NAM priority area of “create and sustain positive work and learning environments and culture” by giving opportunities to support your colleagues, invest in your team, celebrate success, find satisfaction in the sciences, and seek and find healing. By intentionally writing to process emotion and manage work stress, we shift the paradigm for busy clinicians to improve their well-being while simultaneously contributing to academic success.
写作是医学学术生涯的一部分,但许多繁忙的临床医生很难抽出时间写作,并将其视为休息时间的额外工作。这一专业发展视角为写作提供了一个新的视角,即写作不是额外的工作,而是一种健康活动。美国国家医学研究院(NAM)的 "国家医务人员健康计划 "确定了七个优先领域,以采取行动提高医务人员的健康水平。职业写作可以 "支持心理健康,减少耻辱感"(这是美国国家医学研究院的一个明确的优先领域),它允许工作者表达感激之情,进行反思,以及在没有截止日期的情况下写作。写作还通过提供支持同事、投资团队、庆祝成功、在科学中找到满足感以及寻求和找到治愈的机会,解决了 "创造和维持积极的工作和学习环境与文化 "这一国家心理健康计划优先领域的问题。通过有意识地写作来处理情绪和管理工作压力,我们改变了忙碌的临床医生的工作模式,使他们在为学业成功做出贡献的同时,也改善了自己的身心健康。
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引用次数: 0
Writing for Personal and Professional Wellness 为个人和职业健康写作
Pub Date : 2024-02-07 DOI: 10.22454/primer.2024.663516
José E. Rodríguez, Amy Locke, Kendall M. Campbell
Writing is a part of every academic career in medicine, yet many busy clinicians have difficulty finding time to write and may see it as extra work during their time off. This professional development perspective offers a reframing of writing, not as extra work, but as a wellness activity. The National Academy of Medicine’s (NAM) National Plan for Health Workforce Well-being identified seven priority areas where action should be taken to increase wellness in the workforce. Professional writing can “support mental health and reduce stigma” (an explicit NAM priority area) by allowing workers to express gratitude, practice reflection, and write without a deadline. Writing also addresses the NAM priority area of “create and sustain positive work and learning environments and culture” by giving opportunities to support your colleagues, invest in your team, celebrate success, find satisfaction in the sciences, and seek and find healing. By intentionally writing to process emotion and manage work stress, we shift the paradigm for busy clinicians to improve their well-being while simultaneously contributing to academic success.
写作是医学学术生涯的一部分,但许多繁忙的临床医生很难抽出时间写作,并将其视为休息时间的额外工作。这一专业发展视角为写作提供了一个新的视角,即写作不是额外的工作,而是一种健康活动。美国国家医学研究院(NAM)的 "国家医务人员健康计划 "确定了七个优先领域,以采取行动提高医务人员的健康水平。职业写作可以 "支持心理健康,减少耻辱感"(这是美国国家医学研究院的一个明确的优先领域),它允许工作者表达感激之情,进行反思,以及在没有截止日期的情况下写作。写作还通过提供支持同事、投资团队、庆祝成功、在科学中找到满足感以及寻求和找到治愈的机会,解决了 "创造和维持积极的工作和学习环境与文化 "这一国家心理健康计划优先领域的问题。通过有意识地写作来处理情绪和管理工作压力,我们改变了忙碌的临床医生的工作模式,使他们在为学业成功做出贡献的同时,也改善了自己的身心健康。
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引用次数: 0
Moving on From Self-assessment 继续自我评估
Pub Date : 2024-01-23 DOI: 10.22454/primer.2024.624901
Christopher P. Morley
Self-assessment of knowledge and confidence is common in medical education, and there are both philosophical and practical to justifications for it. However, many attempts to establish a correlation between self-assessments of knowledge or confidence and objective measures of knowledge or skill acquisition have failed. While in some circumstances the inclusion or reliance of self-assessment may be warranted, for example when a study is specifically measuring traits or outcomes that rely upon meta-cognition or increases in confidence, it is more often the case that self-assessment is used as a substitute for more objective measures. This is demonstrably flawed, and PRiMER as a journal will be moving away from publishing reports that inappropriately rely upon self-assessed knowledge or confidence as the only study outcomes.
对知识和信心进行自我评估在医学教育中很常见,这在哲学和实践上都有其合理性。然而,许多试图在知识或信心的自我评估与知识或技能掌握的客观测量之间建立相关性的尝试都失败了。虽然在某些情况下,纳入或依赖自我评估可能是有道理的,例如,当一项研究专门测量依赖于元认知或信心增加的特征或结果时,但更常见的情况是,自我评估被用来替代更客观的测量。这显然是有缺陷的,PRiMER 作为一份期刊,将不再发表不适当地依赖自我评估的知识或信心作为唯一研究结果的报告。
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引用次数: 0
US Fourth-Year Medical Students: Diabetes Knowledge and Confidence Dissonance 美国四年级医学生:糖尿病知识与信心偏差
Pub Date : 2024-01-23 DOI: 10.22454/primer.2024.497586
Danielle Pitter, Alyssa M. Indelicato, Christopher P. Morley, Barbara Feuerstein, Ruth S. Weinstock
Introduction: Self-assessed confidence is not a reliable indicator of knowledge levels, as multiple studies have shown; however, it is often used as a measure of knowledge. The purpose of this study is to identify whether the confidence of graduating students in a US medical school to diagnose and treat diabetes is correlated with their diabetes-related knowledge.Methods: We developed a 38-question survey, targeting students’ external experiences, knowledge, and confidence related to the diagnosis, treatment, and prevention of diabetes. The survey includes six self-reported confidence questions and 15 multiple choice-style questions, to test diabetes knowledge. The survey was administered electronically using REDCap to the graduating medical school class (n=176) at Upstate Medical University. We calculated mean knowledge scores and confidence scores were calculated. We used Pearson correlation and t tests to assess for correlations and differences in the collected data. We also reviewed diabetes content in the current curriculum.Results: The response rate was 38%. The mean confidence score was 19.97 out of 30 (SD=3.92) and the mean knowledge score was 9.63 out of 15 (SD=2.09). Total knowledge and confidence scores were not correlated. A positive correlation between confidence in prescribing/adjusting medications to treat patients with type 1 diabetes and knowledge levels was found (R=.325, P=.007). Academic electives, external experiences with diabetes, and demographics did not correlate with knowledge and confidence differences.Conclusions: Students overestimated their ability to adequately manage people with diabetes. Better approaches are needed to prepare future physicians to diagnose and treat diabetes.
导言:多项研究表明,自我评估的信心并不是衡量知识水平的可靠指标;然而,信心却经常被用作衡量知识的标准。本研究旨在确定美国一所医学院即将毕业的学生诊断和治疗糖尿病的信心是否与其糖尿病相关知识相关:方法:我们针对学生在诊断、治疗和预防糖尿病方面的外部经验、知识和信心编制了一份 38 个问题的调查问卷。该调查包括 6 道自述信心题和 15 道多项选择题,用于测试糖尿病知识。我们使用 REDCap 对上州医科大学医学院的毕业班学生(176 人)进行了电子问卷调查。我们计算了平均知识得分和信心得分。我们使用皮尔逊相关性和 t 检验来评估所收集数据的相关性和差异。我们还回顾了当前课程中的糖尿病内容:结果:回复率为 38%。信心平均分为 19.97 分(满分 30 分,标准差=3.92),知识平均分为 9.63 分(满分 15 分,标准差=2.09)。知识总分和信心总分不相关。在处方/调整药物治疗 1 型糖尿病患者的信心与知识水平之间存在正相关(R=.325,P=.007)。学术选修课、糖尿病的外部经验和人口统计学特征与知识和信心差异没有相关性:结论:学生们高估了自己充分管理糖尿病患者的能力。需要更好的方法来培养未来医生诊断和治疗糖尿病的能力。
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引用次数: 0
Identifying Barriers to Precepting Health Professions Learners During the COVID-19 Pandemic 识别在 COVID-19 大流行期间对卫生专业学习者进行实习的障碍
Pub Date : 2024-01-11 DOI: 10.22454/primer.2024.453046
Maha B. Lund, Sonya Green, Allison Leppke, Pamela Vohra-Khullar, Susana Alfonso, Miranda A. Moore
Background and Objectives: The COVID-19 pandemic worsened the shortage of clinical training opportunities for health professions learners. During the pandemic, additional barriers to precepting health professions learners emerged. Understanding preceptors’ perceptions of barriers is a first step to providing learners with the best clinical learning opportunities.Methods: In February 2021, the Emory Primary Care Consortium surveyed primary care providers eligible to precept health professions learners to determine their current precepting status and associated barriers encountered during and since COVID-19.Results: A total of 61 physicians and 11 nurse practitioners (NPs) or physician assistants (PAs) completed the survey. Of the 41 current preceptors, 29 precepted only MD students, 2 MD and PA students, 7 NP students only, and 3 PA students only. Of the 31 respondents who were not precepting, most (21) had precepted before March 2020 and not since. Pandemic-related precepting challenges included low patient volume (12), lack of comfort teaching in a telehealth setting (7), increased external pressure (eg, children at home; 8), and other reasons (12). Overall, 20 respondents were interested in training on incorporating students into the telehealth clinical workflow and 13 in training on teaching and providing feedback remotely.Conclusion: The COVID-19 pandemic placed additional burdens on preceptors in primary care. Preceptors could benefit from training on incorporating students into telehealth visits. Increased understanding of preceptor needs could lead to new resource offerings and improved future medical education.
背景与目标:COVID-19 大流行加剧了卫生专业学习者临床培训机会的短缺。在大流行期间,出现了更多阻碍卫生专业学习者实习的障碍。要想为学员提供最好的临床学习机会,首先要了解实习医生对障碍的看法:2021 年 2 月,埃默里初级医疗联盟对有资格为卫生专业学习者进行预任培训的初级医疗服务提供者进行了调查,以确定他们目前的预任培训状况以及在 COVID-19 期间和之后遇到的相关障碍:共有 61 名医生和 11 名执业护士 (NP) 或执业助理医师 (PA) 完成了调查。在 41 名现任实习医生中,29 人只实习医学博士学生,2 人实习医学博士和 PA 学生,7 人只实习 NP 学生,3 人只实习 PA 学生。在 31 位未进行过戒酒的受访者中,大多数(21 位)在 2020 年 3 月之前进行过戒酒,之后就没有再进行过。与大流行相关的戒酒挑战包括患者数量少(12 人)、在远程医疗环境中教学不便(7 人)、外部压力增加(如家中有孩子;8 人)以及其他原因(12 人)。总体而言,20 名受访者对将学生纳入远程医疗临床工作流程的培训感兴趣,13 名受访者对远程教学和提供反馈的培训感兴趣:结论:COVID-19 大流行给基层医疗机构的实习医生带来了额外的负担。培训如何将学生纳入远程医疗就诊中,可使实习医生从中受益。进一步了解戒酒师的需求可提供新的资源并改善未来的医学教育。
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引用次数: 0
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