Direct observation of community-based ambulatory encounters involving medical students.
Context. - The current shift of predoctoral medical education from inpatient tertiary settings to community-based, ambulatory practice has raised questions about the effect of the medical student on the process of patient care.
- To determine how the presence of a medical student during the ambulatory medical encounter affects the use of clinical time and patient satisfaction.
- Cross-sectional, multimethod study using direct observation of ambulatory care by research-trained nurses.
- A total of 16 community-based family practice offices accepting family practice clerkship students.
- A total of 452 outpatient visits with and without student involvement.
Main Outcome Measures
- Clinical time use as measured by the Davis Observation Code ; patient satisfaction was assessed with the Medical Outcomes Study 9-item visit rating scale.
- When students were involved, physicians spent more time discussing visit expectations (P=03) and less time in history taking (P=007), providing assessment (P=01), and answering questions (P=04).
Despite these differences, patients were equally satisfied with explanations received, and there was no change in the rank order of the 5 most commonly observed physician behaviors.
There was no difference in time spent in treatment planning, physical examination, health education, or social chatting. (...)
Mots-clés Pascal : Science médicale, Etudiant, Enseignement, Soin, Santé, Ambulatoire, Homme
Mots-clés Pascal anglais : Medical science, Student, Teaching, Care, Health, Ambulatory, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0465764
Code Inist : 002B30A09. Création : 03/02/1998.