将姑息医学融入医学教育:培养更具同情心的新一代医生

Regina M. Mackey, Macaila Eick, Sara Jacobsen, Abraham Labrada Satiago, M. Lapid
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摘要

应如何向医科学生传授姑息医学能力?在美国和其他国家,向医科学生传授姑息医学能力已成为共识。卫生机构也认为教授姑息医学能力至关重要。根据桑切斯-赖利和罗斯的研究,医科学生报告说,在完成正规培训后,他们觉得自己在护理老年人、重病患者和垂危病人方面准备得更好了。作者假设,在医学实习期间进行为期一周的姑息医学轮转将提高医学生护理这些病人群体的技能。为期一周的住院病人轮转旨在让梅奥医学院的所有 50 名医科学生掌握姑息治疗的知识基础、沟通技巧、老年体弱和垂死病人的护理以及重症病人的基本疼痛管理。这 50 名学生分别与一个姑息关怀咨询团队轮换,进行病人互动、讲座、在线教学和跨学科团队活动。实践证明,实践学习比单纯使用课堂教学的经典模式更有效,70% 的学生对实践方法给予了积极回应。学习如何在探望复杂疾病患者时应用姑息关怀技能,作为一个教育模块,效果更好。在接受调查的 50 名医学生中,有 35 人(70%)做出了回应,所有回应都是积极的。这种教学方法可以推广到其他高级临终关怀和姑息关怀技能的教学中。
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Integrating Palliative Medicine into Medical Education: Creating a More Compassionate Generation of Physicians
How should Palliative Medicine competencies be taught to medical students? In the United States and other countries, there is a consensus that teaching Palliative Medicine competencies to medical students is essential. Health agencies have also identified teaching Palliative Medicine competencies as crucial. According to Sanchez-Reilly and Ross, medical students reported that they feel better prepared to care for the elderly, patients with severe illness, and dying patients after completing formal training. The authors hypothesized that a one-week rotation with Palliative Medicine during the Medicine Clerkship would improve the medical students’ skills to care for these populations of patients. The one-week inpatient rotation was designed to equip all fifty medical students at Mayo Medical School with a knowledge base of Palliative Care, communication skills, care for elderly frail and dying patients, and basic pain management for patients with severe illness. Each of the fifty students rotated with a Palliative Care consulting team with patient interaction, lectures, online teaching, and interdisciplinary team activities. Hands-on learning proved more effective than using just the classroom teaching classical model, with 70% of students responding positively to the hands-on approach. Learning how to apply Palliative Care skills while visiting patients with complex diseases, showed to be better received as an education module. Out of the fifty medical students surveyed, thirty-five responded (70%), and all responses were positive. This method of teaching could be expanded to teach other advanced hospice and palliative care skills.
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