Teaching clinical decision-making to pediatric residents in an era of managed care.
Pediatric Residency Training in an Era of Managed Care. National Conference. , 1996/05/04.
The growth of managed care has brought a new focus on physician competency in the appropriate use of resources to help patients.
The community of pediatric educators must improve residency curricula and teaching methodologies to ensure that graduates of their programs can effectively and efficiently meet the needs of children and their families.
The educational approach in many pediatric residency programs is an implicit apprenticeship model, with which the residents follow the actions of attending physicians with little attention to scrutiny of the clinical evidence for and against diagnostic and treatment strategies.
Evidence-based medicine stresses to the trainee the importance of the evaluation of evidence from clinical research and cautions against the use of intuition, unsystematic clinical experience, and untested pathophysiologic reasoning as sufficient for medical decision-making.
Managed care also has helped to create a heightened awareness of the need to educate residents to incorporate the preferences of patients and families into diagnostic and treatment decisions.
Trainees must know how to balance their duty to maximize the health of populations at the lowest resource use with their duty to each individual patient and family.
Changes in the residency curriculum will bring change in educational settings and the structure of rotations. (...)
Mots-clés Pascal : Pédiatrie, Soin intégré, Enseignement supérieur, Analyse coût efficacité, Evaluation, Critère décision, Application médicale, Homme, Etats Unis, Amérique du Nord, Amérique, Enseignement, Economie santé
Mots-clés Pascal anglais : Pediatrics, Managed care, Graduate level education, Cost efficiency analysis, Evaluation, Decision criterion, Medical application, Human, United States, North America, America, Teaching, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0301836
Code Inist : 002B30A09. Création : 27/11/1998.