家庭医学住院医师和教员对远程医疗培训优势和局限性的看法。

Sarah A. Venditti, Payam Sazegar, Lance C. Fuchs, Carolyn E. Snarskis
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引用次数: 3

摘要

背景和目的远程医疗已成为一种被高度利用的初级保健形式,要求医学院和住院医师项目开发标准化的远程医疗培训,以满足学习者的教育需求。这项研究强调了在家庭医学(FM)住院医师项目中被认为非常有价值的临床教学和师资发展的特定领域。方法我们根据研究生医学教育认证委员会(ACGME)的里程碑开发了一种需求评估调查工具,并于2020年8月将其分发给郊区FM住院项目的教职员工和居民。我们将每个调查问题映射到ACGME的核心能力,以确定共同的主题。我们进行了两个样本t检验,以比较教员评估中的感知自信和住院医师对关键远程医疗临床技能的表现。结果共有29名受访者(15名教职工,14名居民)完成了调查。住院医师和教职员工都对获得重点病史、排除危险症状、制定鉴别诊断和计划后续护理表示满意。教员们报告说,他们对自己提供医学知识和临床决策反馈的能力充满信心,但也发现需要更好的反馈工具。教员和住院医师都认为有必要在视频访问中更好地教授体检技能。教员和住院医师在评估和执行关键远程医疗技能方面的自信心没有统计学上的显著差异。结论开发有效的远程医疗教育体验应强调教授虚拟交流和体检技能,并开发新的学习者评估方法。
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Family Medicine Resident and Faculty Perceptions About the Strengths and Limitations of Telemedicine Training.
Background and Objectives Telemedicine has become a highly-utilized form of primary care, requiring medical schools and residency programs to develop standardized telemedicine training to meet learners' educational needs. This study highlights specific areas of clinical teaching and faculty development regarded as highly valuable in a family medicine (FM) residency program. Methods We developed a needs assessment survey instrument based on Accreditation Council for Graduate Medical Education (ACGME) milestones and circulated it to faculty and residents at a suburban FM residency program in August 2020. We mapped each survey question to ACGME core competencies to identify common themes. We performed two-sample t tests to compare perceived self-confidence in faculty assessment and resident performance of key telemedicine clinical skills. Results A total of 29 respondents (15 faculty, 14 residents) completed the survey. Both residents and faculty expressed comfort with obtaining a focused history, ruling out red flag symptoms, formulating a differential diagnosis, and planning follow-up care. Faculty reported confidence in their ability to provide feedback about medical knowledge and clinical decision making, but also identified a need for better feedback tools. Both faculty and residents identified a need for better teaching of physical exam skills during video visits. There were no statistically significant differences for perceived self-confidence in evaluating and performing key telemedicine skills between faculty and residents, respectively. Conclusion Development of effective telemedicine educational experiences should emphasize teaching virtual communication and physical exam skills, and developing new approaches to learner evaluation.
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