THE NEW JAPANESE POSTGRADUATE MEDICAL EDUCATION AND QUALITY OF EMERGENCY MEDICAL CARE
THE NEW JAPANESE POSTGRADUATE MEDICAL EDUCATION AND QUALITY OF EMERGENCY MEDICAL CARE
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DOI：
10.1016/j.jemermed.2011.01.020
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发表时间：
2012-09-01
影响因子：
1.5
通讯作者：
Fukui, Tsuguya
中科院分区：
文献类型：
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作者：
Tokuda, Yasuharu;Goto, Eiji;Fukui, Tsuguya
背景：日本最近推出了新的研究生医学教育(PGME)，以提高急诊护理的质量。目的：比较完成新旧PGME计划的医生在提供急救药物方面的护理质量和信心。方法：对279名研究生进行横断面问卷调查，回收问卷208份(占75%)。急诊医学的护理质量是通过26个关于不同临床条件下的治疗选择的问题来衡量的。每个问题有六个回答，包括一个正确的选择。效果大小是用总分差除以分数分布的标准差得出的。对急诊医学的信心使用四个自我报告的项目对各种急救医学环境中治疗急性疾病的信心水平进行评级。结果：新的PGME组的护理质量平均得分(15.3)显著高于旧的PGME组(12.8)。得分的差异为2.5(p<；0.01)，效果大小(0.47)表示中等差异。对调整了医生协变量的总分进行线性回归得到了调整后的分数差为2.5(p<；0.01)和调整后的效应大小为0.47的相似结果。新的PGME小组对提供急救药物的信心也大大增强，这是基于两组之间在所有四个自我报告项目上的显著差异(均为P<；0.05)。结论：与完成旧的PGME计划的医生相比，完成新的PGME计划的日本医生可能提供更高质量的护理，并且对急救医学更有信心。(C)2012年爱思唯尔公司。
Background: The new postgraduate medical education (PGME) was recently introduced to improve quality of emergency care in Japan. Objectives: To compare the quality of care and confidence in provision of emergency medicine between physicians who completed the old and new PGME programs. Methods: A cross-sectional survey was sent to 279 physicians of postgraduate years 4-9, and 208 responses (75%) were received. Quality of care in emergency medicine was measured using 26 questions on treatment choices for various clinical conditions. Each question had six responses, including a single correct choice. Effect size was obtained by dividing the total difference in score by the standard deviation of the score distribution. Confidence in emergency medicine was rated using four self-reported items on the level of confidence in treating acute illnesses in various emergency medicine settings. Results: The mean score for quality of care was significantly higher in the new PGME group (15.3) compared to the old PGME group (12.8). The difference in scores was 2.5 (p < 0.01) and the effect size (0.47) indicated a moderate difference. Linear regression of total scores adjusted for physician covariates produced similar results of an adjusted score difference of 2.5 (p < 0.01) and an adjusted effect size of 0.47. The new PGME group also had significantly greater confidence in provision of emergency medicine based on significant differences between the groups for all four self-reported items (all p < 0.05). Conclusions: Japanese physicians who complete the new PGME program are likely to provide higher quality of care and have greater confidence in emergency medicine compared to those who completed the old PGME program. (C) 2012 Elsevier Inc.