在学生经营的免费诊所实施教育授权小组促进以教育为重点的对话:一个可复制的模式

S. Jager, Emily Hentz, MacKenzie Pairitz, Shae Jansen, Javier Sevilla-Martir
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引用次数: 0

摘要

在印第安纳大学学生外展诊所(IUSOC),缺乏时间专门用于患者教育是一个障碍,在高患者量的环境中进行动机性、移情性的对话。建立教育授权小组(EET)的目的是:(1)通过教育性对话增强患者的能力;(2)增强一群研究生和卫生专业学生在动机性访谈(MI)和患者教育方面的技能。本研究的目的是详细描述EET实施模型,并评估团队成员在实施前三个月的成功和遇到的障碍。15名EET成员被选中并完成了三期培训。在实施三个月后,一份调查分发给了EET的成员。完成了对团队对其作用的定性认识的专题分析,以及对遇到的障碍和培训课程利用情况的定量评估。采用mcnemar检验确定显著性。EET成员发现心肌梗死临床前培训是最有效的(p=0.02),并要求在今年晚些时候进行第二次心肌梗死培训,以及角色扮演培训。成员们发现EET的公共环境是有效的患者-志愿者关系的最大障碍。2020年1月至3月,新冠肺炎疫情迫使诊所关闭,IUSOC成功实施了EET。EET的持续时间缩短是该研究的最大限制;然而,可复制的EET实施模型可作为在学生开办的免费诊所实施以教育为重点的团队的有效起点。未来的步骤包括修改EET模型,扩大团队的跨学科异质性,并通过疾病进展客观地评估EET对患者健康结果的影响,并通过患者评估主观地评估EET对患者健康结果的影响。
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Implementation of an Education Empowerment Team to Promote Education-Focused Conversations in a Student-Run Free Clinic: A Reproducible Model
Lack of time dedicated to patient education is a barrier to motivational, empathetic conversations in the setting of high patient volume at the Indiana University Student Outreach Clinic (IUSOC). The Education Empowerment Team (EET) was created to: (1) empower patients through educational conversations and (2) empower a cohort of graduate and health professional students to grow in the skills of motivational interviewing (MI) and patient education. The purpose of this study is to detail the EET implementation model and evaluate the successes and barriers encountered by team members during its first three months of implementation. Fifteen EET members were selected and completed three training sessions. A survey was dispersed to members of the EET after three months of implementation. Thematic analysis of the team’s qualitative perception of their role, as well as quantitative evaluation of encountered barriers and training session utilization was completed. McNemar’s test was implemented to determine significance. EET members found the MI pre-clinical training to be most utilized (p=0.02) and requested a second, ‘refresher’ MI training later in the year, as well as role-play training scenarios. Members found the public setting of EET encounters to be the largest barrier to effective patient-volunteer relationships. The EET was successfully implemented at the IUSOC from January to March 2020 when COVID-19 restrictions forced clinic closure. The shortened duration of the EET was the largest limitation of the study; yet, the reproducible EET implementation model serves as an effective starting point for the implementation of education-focused teams at student-run free clinics. Future steps involve modifying the EET model, expanding interdisciplinary heterogeneity of the team, and evaluating the impact of EET on patient health outcomes objectively by disease progress and subjectively by patients’ assessments.
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