To determine the feasibility of implementing the Community Outpatient Practice Experience (COPE), a community-based continuity program, in a large, tertiary-care-oriented pediatric residency ; to assess the impact of the continuity program on pediatric residents'experience ; and to compare the experience in a variety of community practice settings.
Continuity clinic settings included a hospital-based residents'group practice (RGP) clinic (1989 through 1991) and a community-based program in which each resident was paired with a practicing pediatrician in the community (1991 through 1993).
Residents in RGP (108.5 resident years) had 5294 encounters with 1568 patients.
In COPE (102.5 resident years), 21978 encounters with 19 235 patients occurred.
COPE residents saw significantly more patients per session (6.2 vs 1.7) than residents in RGP.
The mean patient age in COPE was significantly higher than RGP (5.3 vs 2.6 years).
A greater proportion of encounters in RGP were for health supervision (61% vs 30%), but a greater number of health supervision encounters per resident occurred in COPE.
There was a higher proportion of patients with chronic disease in RGP (38% vs 7%), but a greater number of patients with chronic disease was seen per resident in COPE.
Analysis of COPE data by practice type showed fewer patient encounters per session and a younger patient age in publicly funded sites than in private-or managed-car.
Mots-clés Pascal : Etats Unis, Enseignement professionnel, Médecine, Programme éducatif, Ambulatoire, Soin, Pédiatrie, Etudiant, Interne(étudiant), Amérique du Nord, Amérique
Mots-clés Pascal anglais : United States, Occupational education, Medicine, Educational schedule, Ambulatory, Care, Pediatrics, Student, Resident, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0413121
Code Inist : 002B30A09. Création : 01/03/1996.