Purpose: A community-engaged approach to medicine, particularly primary care, is effective for health promotion. There is, however, limited evidence and no consensus on best training practices to ensure that physicians are trained adequately to practice community-engaged medicine. To define and determine how to fill this gap, the authors conducted a systematic review of literature on community-engaged activities in primary care resident training programs. The study sought to evaluate the quality of studied interventions and assess future research needs.

Method: For this systematic review, the study team searched PubMed, MEDLINE, and PsycINFO using key search terms related to graduate medical education, community engagement activities, and potential outcomes. The team selected and reviewed all English-language articles published through December 2024 that described interventions in which primary care residents participated in activities that occurred in community-based settings. The team analyzed studies with quantitative and qualitative results. They assessed study quality using the Medical Education Research Study Quality Instrument (MERSQI) and assessed the quality of the community-engaged educational activity using a novel instrument called the Medical Education Engagement Quality Index (MEEQI).

Results: The study team identified and reviewed the full texts of 29 articles (10 quantitative, 10 qualitative, and 9 quantitative and qualitative articles). Interventions included community engagement activities with varied settings, study length, and learning objectives. Outcomes included a change in attitudes, knowledge, skills, and career choices. The mean MERSQI score was 9.0 (range, 5.5-11.5), and the mean MEEQI score was 6.2 (range, 4.0-10.0).

Conclusions: The authors' findings revealed limited quality and substantial variability of the current literature. Future research should use more rigorous evaluation methods to determine which community-engaged curricular components can most effectively provide primary care resident physicians with the skills needed to provide high-quality primary care, particularly for vulnerable populations.

Copyright © 2025 the Association of American Medical Colleges.

目的： 社区参与式的医学方法，特别是初级保健，在促进健康方面是有效的。然而，关于最佳培训实践的证据有限，并且没有达成共识来确保医生能够充分接受训练以进行社区参与式医疗实践。为了定义这一缺口并确定如何填补它，作者们对初级保健住院医师培训项目中社区参与活动的相关文献进行了系统回顾。该研究旨在评估所研究干预措施的质量并评估未来的研究需求。

方法： 在这项系统性回顾中，研究团队使用与毕业后医学教育、社区参与活动以及潜在结果相关的关键词在PubMed、MEDLINE和PsycINFO数据库中进行搜索。该团队选择了所有通过2024年12月发表的英文文章，并且这些文章描述了初级保健住院医师参与社区环境中发生的活动的情况。该团队分析了具有定量和定性结果的研究。他们使用医学教育研究质量工具（MERSQI）评估研究质量，同时使用一种称为医学教育参与质量指数（MEEQI）的新工具来评估社区参与式教育活动的质量。

结果： 研究团队确定并审查了29篇文献的全文（其中10篇为定量研究、10篇为定性研究，以及9篇同时包含定量和定性内容的研究）。干预措施包括在不同设置、研究长度及学习目标下进行的社区参与活动。结果包括态度变化、知识水平提高、技能提升以及职业选择的变化等。MERSQI评分平均值为9.0（范围：5.5-11.5），而MEEQI评分平均值为6.2（范围：4.0-10.0）。

结论： 作者们的研究发现显示了当前文献质量有限且存在显著的变异性。未来研究应使用更为严格的评价方法来确定哪些社区参与式课程组件能够最有效地为初级保健住院医师提供必要的技能，以向脆弱人群提供高质量的一级医疗护理。

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