在临床教学中遵循患者知情同意原则,真正实现以患者为中心。

IF 1.6 Q3 HEALTH CARE SCIENCES & SERVICES Journal of Patient Experience Pub Date : 2024-08-14 eCollection Date: 2024-01-01 DOI:10.1177/23743735241273669
Hongnan Ye
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引用次数: 0

摘要

以病人和疾病为中心的临床教学被认为是医学教育的基石。目前的临床教学越来越多地在门诊环境中进行,但这会给患者带来不适。尽管许多专业组织已针对这一问题制定了一套伦理考虑因素,用这些考虑因素来指导诊所的门诊程序,但这些指导方针在门诊实践中并没有得到很好的遵守。我作为一名湿疹患者在皮肤科门诊的经历就是很好的证明。在我看来,医学生在门诊环境中观察临床互动的教学方法本身并没有问题,真正的问题在于没有告知患者医学生的存在,也没有允许患者行使拒绝的权利。因此,我们提出以下建议:首先,学术医学中心应定期对医生和医学生进行培训,确保他们充分了解专业组织制定的伦理指南中的内容,并认识到在临床实践中遵守这些指南的重要性。其次,每次临床教学活动都应征得病人的知情同意,并以病人的意愿为基础。最后,建议医院建立适当的评估机制,对医生遵守伦理准则的情况进行评估,并对不遵守准则的医生和医学生进行继续教育和培训。
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Follow Informed Patient Consent in Clinical Teaching in Order to Achieve a Truly Patient-Centered Approach.

Patient- and disease-focused clinical teaching is considered the cornerstone of medical education. Current clinical teaching is increasingly taking place in outpatient settings, but this can cause discomfort to patients. Although many professional organizations have developed a set of ethical considerations in response to this issue to use these considerations to guide clinics in their outpatient procedures, these guidelines are not well adhered to in outpatient practice. My experience as an eczema patient in a dermatology outpatient is good evidence of this. In my opinion, there is nothing inherently wrong with the pedagogy of medical students observing clinical interactions in outpatient settings; the real problem lies in not informing the patient of the medical student's presence or allowing the patient to exercise his or her right of refusal. Therefore, the following recommendations are made: First, academic medical centers should provide regular training to doctors and medical students to ensure that they are fully aware of what is contained in the ethical guidelines established by the professional organizations and that they recognize the importance of adhering to these guidelines in clinical practice. Second, each clinical teaching activity should have the informed consent of the patient and be based on the patient's wishes. Finally, it is recommended that hospitals establish appropriate evaluation mechanisms to assess doctors' compliance with the ethical guidelines and provide continuing education and training for doctors and medical students who fail to comply.

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来源期刊
Journal of Patient Experience
Journal of Patient Experience HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.00
自引率
6.70%
发文量
178
审稿时长
15 weeks
期刊最新文献
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