A randomized, controlled trial of bedside versus conference-room case presentation in a pediatric intensive care unit
A randomized, controlled trial of bedside versus conference-room case presentation in a pediatric intensive care unit
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DOI：
10.1542/peds.2007-0107
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发表时间：
2007-08-01
期刊：
影响因子：
8
通讯作者：
Cyr, Claude
中科院分区：
文献类型：
--
作者：
Landry, Marc-Antoine;Lafrenaye, Sylvie;Cyr, Claude
目标.在床边进行的病例介绍和教学正在下降。在文献中，患者对床旁病例介绍和会议室病例介绍的偏好是不同的。居民似乎更喜欢会议室。本研究的目的是确定是否有一个满意度和舒适度之间的差异床旁病例介绍和会议室的情况下，在PICU住院患者的父母和住院医师在培训中的PICU.Methods。在同一住院医师、主治儿科医生和父母在场的情况下，在PICU住院的每名儿童连续2次晨查房，都有资格参加本研究。研究开始于第一个病人在PICU入院后的病例介绍。随机化是在第一个病例介绍时进行的：床边或会议室。第二天，进行了另一种类型的病例介绍。每一轮结束后，家长和居民填写一份表格。22名患者的27名父母回答了两份问卷，21份问卷由居民回答。家长的满意度显着较高，在床边的情况下介绍（96比92，回答报告在100毫米的线性规模），他们更喜欢床边的情况下介绍（95比15），他们更舒适参加床边教学（89比19）。住院医师的满意度和他们对实际病例介绍的舒适度没有差异。另一方面，住院医师在会议室病例介绍期间提出问题（84 vs 69）和被问问题（85 vs 67）的舒适度明显更高。共有81%的家长希望下一次的情况下介绍将发生在床边。这项研究表明，在PICU的情况下，似乎满足父母没有造成太多的不适居民在床边进行的临床病例介绍的可行性。因此，床边病例展示可能是大学医院一个非常好的教学策略。
Objectives. Case presentation and teaching performed at the bedside are declining. Patients' preference between bedside case presentation and conference-room case presentation is divergent in the literature. Residents seem to prefer the conference room. The objective of this study was to ascertain whether there was a difference of satisfaction and comfort between bedside case presentation and conference-room case presentation for the parents of patients hospitalized in the PICU and for the residents in training in the PICU.Methods. Every child hospitalized in the PICU who had 2 consecutive morning rounds, performed in the presence of the same resident, attending pediatrician, and parent, was eligible for the study. The study began with the first patient's case presentation after admission in the PICU. Randomization was on the first case presentation: bedside or conference room. On the second day, the other type of case presentation was performed. After each round, the parents and the resident filled out a questionnaire.Results. Twenty-seven parents of 22 patients answered both questionnaires, and 21 questionnaires were answered by residents. Parents' satisfaction was significantly higher during bedside case presentation ( 96 vs 92, answers reported on a 100-mm linear scale), they preferred bedside case presentation ( 95 vs 15), and they were more comfortable attending bedside teaching ( 89 vs 19). There was no difference in the residents' satisfaction nor in their comfort giving the actual case presentation. Residents, on the other hand, were significantly more comfortable asking questions ( 84 vs 69) and being asked questions ( 85 vs 67) during conference-room case presentation. A total of 81% of the parents wished that the next case presentation would take place at the bedside.Conclusions. This study demonstrates the feasibility of a clinical case presentation performed at the bedside in the PICU context that seems to satisfy parents without causing too much discomfort to residents. Thus, bedside case presentation could be a very good teaching strategy in university hospitals.