地域医療と健康教育

抽象的な

Family Medicine Resident Education: An Innovative Model of Community Medicine Training

Nora Gimpel, Patti Pagels, Vibin Roy, Zoe Tullius and Tiffany Billmeier

Introduction: Family Medicine residents benefit from comprehensive training models which incorporate community medicine and population health principles into patient care. This paper describes an innovative Community Medicine (CM) rotation and reports its effectiveness. Objectives of the rotation are to train residents to 1) identify and intervene in community health problems, 2) respond to particular health issues and care for local cultural groups, 3) coordinate local community health resources in the care of patients, 4) focus on underserved population and 5) assimilate into the community and its organizations. Method: Residents (N=21) participated in a longitudinal CM rotation that included 8 weeks (2 blocks) in the first year and 4 weeks (1 block each) in second and third years. Resident activities included several community agency site visits, health education, journal clubs, didactics, community-based participatory research (CBPR) and direct patient care. Selected residents (2 per year) participated in a targeted community action research experience (CARE). Residents completed a pre-test evaluating their knowledge and attitudes of CM (1=strongly disagree; 5=strongly agree). After the rotation, residents completed a post-test and rated their perceptions of whether the curriculum goals were accomplished (1=not accomplished; 5=accomplished). Results: Residents’ knowledge and attitudes improved significantly on most areas of Community Medicine (CM) (p<0.05). All residents reported that the CM rotation increased their knowledge of health promotion activities (5.00). Residents also felt strongly about their ability to locate community resources of benefit to their patients (4.87), care for patients in non-traditional sites (4.86) and assimilate into the community after graduation (4.81). Conclusion: Residents evaluated the CM rotation favorably. Our rotation is a comprehensive model that can be used by other residencies to train community responsive physicians and meet ACGME guidelines. Rotation activities can be tailored to the specific needs of other residencies and their communities.