The impact of residency training on physicians' AIDS-related treatment practices: a longitudinal panel study.
The impact of residency training on physicians' AIDS-related treatment practices: a longitudinal panel study.
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住院医师培训对医生艾滋病相关治疗实践的影响：纵向小组研究。
DOI：
10.1097/00001888-199905000-00021
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
Berry,CA
中科院分区：
文献类型：
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作者：
Yedidia,MJ;Berry,CA
目的探讨住院医师培训对艾滋病相关治疗实践的影响。方法：作者对1989年毕业于纽约州6所医学院的394名医生进行了一项全国性的纵向小组研究。数据收集于参与者在医学院的第四年、住院医师培训的第三年以及他们从医学院毕业后的六年。调查问卷旨在了解与艾滋病相关的实践行为，包括避免侵入性手术、尽量减少接触、重视艾滋病预防和教育以及接受治疗的艾滋病患者数量。结果住院医师培训的各个方面对医生如何照顾艾滋病患者有持续的影响，但对他们治疗的患者数量没有影响。治疗实践的决定因素包括住院环境的各个方面(例如，强调解决问题，学生导向；p<。01)，教师的特点（例如，对教学的承诺，对不同观点的容忍），对病人护理的玩世不恭(p<。001)，社会偏见(同性恋恐惧症和对静脉注射吸毒者的厌恶；p<。001)，以及与艾滋病相关的态度(p<。01)。结论住院医师培训的根本性改变，与学习者为中心的教育有关，可以提高医生对艾滋病患者的治疗水平。
PURPOSETo determine the effects of aspects of residency training on AIDS-related treatment practices.METHODThe authors conducted a nationwide longitudinal panel study of 394 physicians who graduated in 1989 from six medical schools in New York State. Data were collected during the participants' fourth year of medical school, their third year of residency training, and six years after they had graduated from medical school. Questionnaires sought information about AIDS-related practice behaviors, including avoiding invasive procedures, minimizing contact, emphasizing AIDS prevention and education, and volume of people with AIDS treated.RESULTSAspects of residency training had a sustained impact on how the physicians cared for patients with AIDS but not on the numbers of patients they treated. Determinants of treatment practices included aspects of the residency environment (eg, emphasis on problem solving, student orientation; p<. 01), characteristics of the faculty (eg, commitment to teaching, tolerance of varied viewpoints), cynicism about patient care (p<. 001), social biases (homophobia and aversion to intravenous drug users; p<. 001), and AIDS-related attitudes (p<. 01).CONCLUSIONSFundamental changes to residency training, all of which are associated with learner-centered education, can improve physicians' treatment of their patients with HIV and AIDS.