Novel first-year curriculum in high-value care
Novel first-year curriculum in high-value care
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DOI：
10.1111/tct.12989
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发表时间：
2019-10-01
期刊：
影响因子：
1.8
通讯作者：
Pahwa, Amit K.
中科院分区：
文献类型：
--
作者：
Steele, Christopher;Cayea, Danelle;Pahwa, Amit K.
背景大多数医学院在临床期间教授高价值护理（HVC）课程。目前，还没有任何研究证明在医学院第一年教授给学生的HVC课程的有效性。方法2013年至2017年，约翰霍普金斯医学院466名一年级医学生中共有118人参加了HVC课程，该课程提供了实践成本意识临床医学所需的初步框架。通过比较完成课程的学生的表现与未接受培训的学生的表现，通过标准化的患者遇到肌肉骨骼背痛以及如何处理患者的成像请求，对课程进行了评估。卡方检验用于评估标准化患者就诊过程对性能的影响。结果：参加HVC课程的学生与他们的同行相比，更有可能向患者保证背痛是一种简单的紧张（48%对31%），并且不太可能就如何进行管理向导师寻求帮助（11%对29%）[卡方（2）（4，n = 466）= 14.28，p = 0.007]。参加HVC课程但尚未接受培训的学生与参加另一门选修课的学生之间没有差异[chi（2）（4，n = 385）= 8.73，p = 0.07]。讨论这是第一项研究，以评估一年级医学生的HVC课程的有效性，它表明承诺，他们可以获得一些必要的技能，在模拟临床环境中的成本效益的做法。这是第一项评估一年级医学生HVC课程有效性的研究，它表明，他们可以获得一些必要的技能，以实现成本效益的做法
Background Most medical schools teach a high-value care (HVC) curriculum during the clinical years. Currently, there lacks any research demonstrating the effectiveness of the HVC curriculum taught to students in their first year of medical school. Methods A total of 118 of 466 first-year medical students at Johns Hopkins School of Medicine between 2013 and 2017 enrolled on an HVC course that provided the initial framework necessary to practice cost-conscious clinical medicine. The curriculum was evaluated by comparing the performance of students who completed the course with the performance of students without training, through a standardised patient encounter on musculoskeletal back pain and how to approach a patient's request for imaging. Chi-square testing was used to assess the impact of the course on performance in a standardised patient encounter. Results Students enrolled on the HVC course were more likely, compared with their counterparts, to assure patients that back pain was a simple strain (48 versus 31%), and were less likely to ask for preceptor help on how to proceed with management (11 versus 29%) [chi(2)(4, n = 466) = 14.28, p = 0.007]. There were no differences between students enrolled on the HVC course who had not yet received training compared with students taking another elective [chi(2)(4, n = 385) = 8.73, p = 0.07]. Discussion This is the first study to assess the effectiveness of an HVC curriculum for first-year medical students, and it demonstrates promise that they can acquire some skill sets necessary for cost-effective practice in a simulated clinical setting. This is the first study to assess the effectiveness of an HVC curriculum for first-year medical students, and it demonstrates promise that they can acquire some skill sets necessary for cost-effective practice