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首页> 外文期刊>Academic Medicine: Journal of the Association of American Medical Colleges >Medical student exposure to components of the patient-centered medical home during required ambulatory clerkship rotations: implications for education.
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Medical student exposure to components of the patient-centered medical home during required ambulatory clerkship rotations: implications for education.

机译：在要求的门诊职员轮换期间，医科学生接触以患者为中心的医疗之家的组成部分：对教育的影响。

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PURPOSE: To determine the extent to which third-year medical students are exposed to elements of the patient-centered medical home (PCMH) during required family medicine (FM) clerkships and how this exposure varies among a sample of medical schools. METHOD: In 2008, the authors conducted a cross-sectional survey of 104 ambulatory teaching practices that host required third-year FM clerkship students from nine U.S. medical schools. Descriptive statistics characterized learning settings and the status of PCMH features, and generalized linear mixed models examined variation among medical schools (as the 104 clinics were nested within nine medical schools). RESULTS: Participating schools captured data on 104 eligible clerkship sites (44%). These practices were primarily community-based, single-specialty clinics (n = 48; 46%), and more than half (n = 55; 53%) were part of integrated health systems. Electronic health records (EHRs) were in place in 60 (58%), and no significant difference existed in EHR use according to medical school, despite up to a 10-fold variation from school to school in other PCMH features. Among sites with EHRs, 8 (14%) did not allow access to medical students. Preceptor attitudes about how practice transformation and new information technology are affecting the quality of medical education differ widely from site to site. CONCLUSIONS: Primary care transformation toward the PCMH is already well under way in a national sample of FM teaching sites, and this transformation is having important effects on medical student education.
机译：目的：确定在要求的家庭医学（FM）培训期间，三年级医科学生接触以患者为中心的医疗之家（PCMH）的程度，以及该接触在各个医学院校之间如何变化。方法：2008年，作者对104种门诊教学实践进行了横断面调查，这些实践接受了来自美国9所医学院校的3年级FM实习学生的要求。描述性统计描述学习设置和PCMH功能的状态，并使用广义线性混合模型检查了医学院之间的差异（因为104所诊所嵌套在9所医学院中）。结果：参与的学校在104个合格的书记员网站上收集了数据（44％）。这些做法主要是基于社区的单一专科诊所（n = 48; 46％），一半以上（n = 55; 53％）是综合卫生系统的一部分。电子健康记录（EHR）已有60个（58％），尽管医学院之间在其他PCMH功能方面的差异高达10倍，但根据医学院的使用，电子病历的使用没有显着差异。在拥有电子病历的网站中，有8个（14％）不允许访问医学院的学生。在实践转变和新信息技术如何影响医学教育质量方面，各教职员工的态度在各地之间存在很大差异。结论：在全国范围内的调频教学地点中，已经向PCMH进行了初级保健转型，该转型对医学生的教育产生了重要影响。

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