基于健康公平的家庭医学居民社会文化教育

Karen Isaacs, C. Sotir
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摘要

背景:跨多个医学专业的里程碑项目呼吁住院医师关注影响健康结果的社会文化因素。尽管长期存在不同的健康结果,但很少有很好的方法来教授这些主题给住院医师。目的:本案例研究反映了一个旨在为我们的家庭医学住院医师建立有意义的社会文化课程的质量改进过程。方法:新汉诺威地区医疗中心的家庭医学住院医师是一个6-6-6的社区项目,之前接受过有限的正式社会文化培训。2017年,与文化多样性相关的节目被纳入了为期四周的驻校教育时间。这一努力的定性反馈有助于指导2018年在教学法和体验式学习的基础上制定更稳健、更有意的纵向一年卫生公平课程方法。对住院医师知识和能力的自我报告定量数据进行了审查,以评估该课程。结果:18名居民中有18名(100%)在2017-2019学年期间每年接受社会文化教育。第一年的定性反馈表明,对这些主题的理解参差不齐。更新后的第二年纵向方法的数据显示,居民对卫生公平主题的知识和应用能力有了显著提高。结论:我们的个案研究表明,纵向课程与概念应用健康公平的机会可以影响居民的社会文化知识和技能。我们项目的成功也为其他可能缺乏时间和/或资源的小型社区项目带来了希望。
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Family medicine resident sociocultural education using health equity
Background : The milestone project across multiple medical specialties calls for resident attention to sociocultural factors that affect health outcomes. Despite the long-standing reality of disparate health outcomes, there are few well-described approaches for teaching such topics to medical resident physicians. Objectives : This case study reflects a quality improvement process aimed at establishing a meaningful sociocultural curriculum for our family medicine residents. Methods : The Family Medicine Residency at New Hanover Regional Medical Center is a 6-6-6 community-based program with previous limited formal sociocultural training. In 2017, programming related to cultural diversity was mixed into resident educational time over a single four-week period. Qualitative feedback from that effort helped guide the development of a more robust and intentional longitudinal year-long health equity curricular approach in 2018, based on didactics and experiential learning. Self-reported quantitative data on resident knowledge and ability were reviewed to evaluate that curriculum. Results : 18 of 18 residents (100%) were exposed yearly to sociocultural education over two academic years (2017-2019). Qualitative feedback in year one suggested mixed uptake of the topics. Data from the updated year two longitudinal approach revealed significant improvements in resident knowledge about, and ability to apply, health equity topics. Conclusion : Our case study suggests that a longitudinal curriculum with opportunities for concept application to health equity can impact residents’ sociocultural knowledge and skills. The success at our program also holds promise for other small community-based programs that may be short on time and/or resources.
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