جستجوی مقالات مرتبط با کلیدواژه « Outpatient Clinics » در نشریات گروه « پزشکی »

This study reviews articles published in the last two decades to determine the pros and cons of virtual outpatient education for undergraduate medical students and residents. A review of articles published between 2001 and 2021 in PubMed, Scopus, ERIC, and google scholar databases. Keywords for this search were: Ambulatory care/Outpatient clinics and education, and medical/internship and residency. The emphasis of this study was on the implementation of any kind of E-learning in outpatient clinics. Out of 5100 in the initial monitoring, 168 articles were reviewed based on the full text. Finally, information on 11 articles was extracted. Results were summarized in 4 areas: methods and tools used in e-learning, benefits of e-learning, challenges and limitations of e-learning, and student support. The main methods used were telemedicine via video conferencing and telephone calls, especially for residents. Other were virtual clinics with a simulated patient, as well as online educational modules. The main preponderances were: increasing knowledge and skills of telemedicine, improving medical knowledge and skills, access to educational resources even during patients visit, the possibility of learning at any time and place, and betterment of the quality of care. The main challenges were lack of technological literacy and lack of Internet access for some patients, time-consuming entry of patient information for students, reduction of clinical experiences, the unfeasibility of acquiring full skills in performing physical examinations, or some technical and procedural skills and hardware/software technological problems. Regarding student support, the main activity includes holding orientation sessions on new approaches for trainees. Due to the urgency of using virtual outpatient education in the corona era, it is predicted that in the post-corona era, we will see a tendency to use this method by stakeholders. Certainly, citing the results of original articles and reviewing them, similar to the present study, can make it possible to implement qualified E-learning innovation in clinics with quality in the future.

The visit length is considered one of the indicators for assessing patients’ satisfaction. Factors such as waiting time for getting a visit affects the desirability of the visit.

This study aimed to investigate the visit length and waiting time of patients in public and private clinics in Tabriz.

This is a descriptive-analytic study conducted in five clinics in 2018. A questionnaire-based survey was used to collect data from 386 participants recruited through simple random sampling. Mann-Whitney U and Kruskal-Wallis tests were applied to analyze the data using SPSS version 22.0.

Overall, the mean visit length was 25.5 and 25.4 min in public and private centers, respectively, while the mean waiting time was 141.2 and 156.4 min in public and private centers, respectively. There was no significant difference between public and private centers regarding the visit length (P > 0.05); however, there was a significant difference between public and private centers in terms of waiting time (P < 0.05).

The waiting time was too much, especially in private clinics, which can negatively affect patient satisfaction. Therefore, suggested interventions may consist of using internet and telephone admission, scheduling a waiting list, and requiring physicians to be present on time.

In order to improve outpatient education, it is necessary to carry out formative standard evaluation to reveal the strengths and weaknesses to improve planning the quality of clinical education. Due to numerous challenges in clinical education, the present study was conducted to determine the extent to which outpatient education standards were achieved in the major departments of Shiraz Medical School.

In this quantitative combined, cross‑sectional and practical investigation in the academic year 2018–2019, 178 interns who had passed the outpatient education in the four major wards (internal medicine, pediatrics, gynecology, and surgery) in Shiraz Medical School were randomly selected. A 26‑item researcher‑made questionnaire, based on the Handbook of the Ministry of Clinical Education (Outpatient Education) for Health and Medical Education’s Criteria and indicators, was used in three areas of preparation, timing and implementation; and the psychometric properties of the questionnaire were determined. For quantitative data analysis, SPSS version 22 was used. Furthermore, we performed a qualitative study through semi‑structured interviews with 16 interns and analyzed the data using MAXQDA 10 software.

The results of the quantitative study showed that 8.4% of interns evaluated the program as poor, 66.3% moderate, and 25.3% good. The qualitative study showed that number and diversity of patients, instructor’s educational model, and number of interns had a significant role.

Although the outpatient teaching in the four major departments of Shiraz Medical School was evaluated relatively acceptable, it is far from the ideal point and need to be improved.

Overcrowding is an important problem for outpatient services in healthcare facilities. Patient flow analysis (PFA) is a useful method for identifying inefficiencies in and facilitating patient flow. PFA was used to estimate patient wait time and determine how different clinical disciplines impact wait times in the studied hospital. This cross-sectional study investigated a study population comprised of outpatients who referred to clinics at a general hospital in Tehran, Iran. A total of 3836 samples were selected from different stations. Nonrandomized quota sampling was used, and data was gathered using workflow checklists, the content validity of which was proven by experts and hospital authorities. SPSS statistical software was used for data analysis. Total patient stay in the outpatient setting was an estimated 77 minutes (without considering para-clinic units and pharmacy). More than 90% of this time was spent waiting. The wait time of patients at the clinic was greater than that at other stations, and it was less at the cash station than at other stations. Wait times varied at different clinics (P value < 0.001) and were correlated with physician delay (P value < 0.001). The most important result of using PFA in the outpatient setting was managing wait times. This study indicated that a considerable amount of a patient’s total stay in the system was related to waiting for physical examinations. This suggests that the first priority in improving the system should be managing patient wait times for physical examinations.

Feedback cards are recommended as a feasible tool for structured written feedback delivery in clinical education while effectiveness of this tool on the medical students’ performance is still questionable. The purpose of this study was to compare the effects of structured written feedback by cards as well as verbal feedback versus verbal feedback alone on the clinical performance of medical students at the Mini Clinical Evaluation Exercise (Mini-CEX) test in an outpatient clinic.
This is a quasi-experimental study with pre- and posttest comprising four groups in two terms of medical students’ externship. The students’ performance was assessed through the Mini-Clinical Evaluation Exercise (Mini-CEX) as a clinical performance evaluation tool. Structured written feedbacks were given to two experimental groups by designed feedback cards as well as verbal feedback, while in the two control groups feedback was delivered verbally as a routine approach in clinical education.
By consecutive sampling method, 62 externship students were enrolled in this study and seven students were excluded from the final analysis due to their absence for three days. According to the ANOVA analysis and Post Hoc Tukey test, no statistically significant difference was observed among the four groups at the pre-test, whereas a statistically significant difference was observed between the experimental and control groups at the post-test (F=4.023, p=0.012). The effect size of the structured written feedbacks on clinical performance was 0.19.
Structured written feedback by cards could improve the performance of medical students in a statistical sense. Further studies must be conducted in other clinical courses with longer durations.