TY - JOUR AU - Yin, Leena AU - Ng, Fiona AU - Rutherford-Rojas, Mateo AU - Williams, Mia AU - Cornes, Susannah AU - Fernandez, Alicia AU - Garcia, Maria E AU - Khoong, Elaine C PY - 2022 DA - 2022/8/11 TI -评估医学生在远程医疗中应对语言障碍的准备情况:横断性调查研究JO - JMIR Med Educ SP - e36096 VL - 8 IS - 3 KW -口译员KW -语言障碍KW -医科学生KW -医学教育KW -英语水平有限KW -远程保健KW -远程医疗KW -在线教育KW -临床医生KW -卫生保健专业人员AB -背景:COVID-19大流行大大增加了美国的远程保健使用。英语水平有限的患者在获得医疗保健方面面临障碍，如果服务提供者与专业翻译合作，这种障碍可能会减轻。然而，如果临床医生没有接受与口译人员合作的培训，远程保健可能会加剧差距。尽管医学专业的学生现在以前所未有的规模参与远程医疗，但还没有发表过跨越语言障碍的数字化医疗的教育创新。目的:本研究旨在探讨高等医学生在远程医疗接触中护理LEP患者的信心。方法:我们于2020年8月和9月对一所美国机构的医学学生进行了一项关于临床见习工作的书面调查。我们评估了学生与口译人员合作的整体信心;有信心在面对面和远程医疗接触中完成8项临床任务;与说英语的患者相比，在面对面和远程医疗会面中，对LEP患者执行5种不同临床任务的频率。 Wilcoxon signed-rank tests and chi-square tests were used to compare confidence and task performance frequency, respectively, for patients with LEP versus English-speaking patients during telehealth encounters. Students were also asked to identify barriers to care for patients with LEP. The free-response questions were qualitatively analyzed using open coding to identify key themes. Results: Of 300 medical students surveyed, 121 responded. Furthermore, 72 students answered >50% of questions and were included in the analyses. Compared to caring for patients with LEP during in-person encounters, respondents were less confident in working with interpreters (P<.001), developing trust (P<.001), identifying agenda (P=.005), eliciting preferences for diabetes management (P=.01), and empowering patients in lifestyle modifications (P=.04) during telehealth encounters. During both in-person and telehealth encounters, approximately half of students (40%-78%) reported engaging less frequently in every clinical task with patients with LEP and this was as low as 22% (13/59) for some tasks. Students identified these key barriers to care for patients with LEP: time pressure, interpretation quality and access, technical difficulties, cultural differences, and difficulty with rapport building. Conclusions: Advanced medical students were significantly less confident caring for patients with LEP via telehealth than in person. Broader implementation of training around navigating language barriers is necessary for telehealth care, which has rapidly expanded in the United States. Our study identified potential key areas for curricular focus, including creating patient-centered agendas and management plans within the constraints of virtual settings. These developments must take place simultaneously with systems-level improvements in interpreter infrastructure to ensure high-quality care for linguistically diverse patients. SN - 2369-3762 UR - https://mededu.www.mybigtv.com/2022/3/e36096 UR - https://doi.org/10.2196/36096 UR - http://www.ncbi.nlm.nih.gov/pubmed/35969421 DO - 10.2196/36096 ID - info:doi/10.2196/36096 ER -