Response to Chen, Lee, and Chen.
Response to Chen, Lee, and Chen.
复制标题
回应陈、李和陈。
DOI：
10.1007/s11606-023-08370-6
复制
发表时间：
2023
影响因子：
5.7
通讯作者：
Soni,NilamJ
中科院分区：
文献类型：
--
作者：
Nathanson,Robert;Soni,NilamJ
我们感谢陈博士、李博士和陈博士的真知灼见，并将回答他们提出的三个问题。首先，所有担任初级教员的住院总医师在开始担任住院总医师之前的6周内，都接受了由住院总医师负责的1：1培训。除了审查程序技术，住院总培训的重点是如何教和监督程序正在执行的经验不足的操作员，特别是内科实习生。住院总医师在被允许独立担任主治医生之前，由程序服务主任签字。所有手术均由实习生在住院总医师的直接监督下进行。其次，关于每个实习生的手术尝试和成功次数，我们不幸没有这些数据。尽管这些数据值得审查，但鉴于每天收到的大量手术咨询，收集此类细粒度数据是不可能的。因此，我们通过分析总体数据而不是像之前的几项研究那样通过分析单个实习生来评估学习有效性。1-5第三，在1个月的手术服务轮换期间，我们估计实习医生通常进行5次或更多穿刺，2 - 4次胸腔穿刺，0 - 3次腰椎穿刺，关节穿刺或中心线放置。值得注意的是，这些数字每月变化很大。关于按手术类型划分的实习生学习满意度，我们没有收集这些数据，但可能会考虑在未来的课程评估中收集这些数据。
We appreciate the insightful comments of Drs. Chen, Lee, and Chen and will respond to the three questions they raise. First, all of the chief residents who served as junior faculty to run the procedure service were trained 1: 1 by the procedure service director during a 6-week period prior to the start of their year as chief resident. In addition to reviewing procedural techniques, chief resident training focused on how to teach and supervise procedures being performed by less experienced operators, specifically internal medicine interns. Chief residents were signed off by the procedure service director before being allowed to serve independently as the attending physician of service. All procedures were performed by interns under the direct supervision of a chief resident. Second, regarding the number of procedure attempts and successes per intern, we unfortunately do not have this data. Although such data would be interesting to review, collecting such granular data was not possible given the high number of procedure consults received daily. Thus, we evaluated the learning effectiveness by analyzing data in aggregate rather than by individual intern, as done in several prior studies. 1–5 Third, during the 1-month procedure service rotation, we would estimate that interns generally performed 5 or more paracentesis, 2 to 4 thoracentesis, and 0 to 3 lumbar punctures, arthrocenteses, or central line placements. It is important to note that these numbers varied greatly on a monthly basis. With respect to intern learning satisfaction by procedure type, we did not collect this data but may consider collecting it in future course evaluations.