Cusum analysis is a useful tool to assess resident proficiency at insertion of labour epidurals
Cusum analysis is a useful tool to assess resident proficiency at insertion of labour epidurals
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DOI：
10.1007/bf03018712
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发表时间：
2003-08-01
期刊：
影响因子：
--
通讯作者：
Halpern, SH
中科院分区：
文献类型：
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作者：
Naik, VN;Devito, I;Halpern, SH
目的：累积和（cusum）分析是一种统计和图形工具，用于检查连续事件随时间的趋势。它已被用来确定熟练的技术程序。我们用累积量来确定熟练掌握我们的培训program.Methods：不熟悉硬膜外麻醉的居民在六个月的医院轮换记录他们的劳动硬膜外成功和失败的劳动硬膜外尝试的数量。失败定义为硬脑膜穿刺或将手术交给工作人员。使用10%的可接受失效率进行累积和分析。居民被认为有能力时，他们的图低于计算的累积和boundary.Results：11名麻醉居民被招募。6个月内硬膜外尝试的次数从75次到128次不等。10名居民达到能力之间的一个和85次尝试的累积。结论：经过一段时间的培训，住院医师有望独立完成分娩硬膜外插入的技能。这项研究表明，一些居民可能需要多达75次尝试，以确保熟练。培训项目可以使用累积和来跟踪他们的住院医师的技术技能的进展，以保证足够的经验。
Purpose: Cumulative sum (cusum) analysis is a statistical and graphical tool that examines trends for sequential events over time. It has been used to determine proficiency in technical procedures. We used cusum to determine the number of labour epidural attempts necessary for proficiency in our training program.Methods: Residents unfamiliar with epidural anesthesia kept a log of their labour epidural successes and failures during a six-month hospital rotation. Failure was defined as a dural puncture or relinquishing the procedure to staff. Cusum analysis was performed using an acceptable failure rate of 10%. Residents were deemed competent when their graph remained below the calculated cusum boundary.Results: Eleven anesthesia residents were recruited. The number of epidural attempts over six months ranged from 75 to 128. Ten residents attained competency by cusum between one and 85 attempts. One resident failed to achieve competency by cusum after 75 attempts.Conclusion: After a period of training, residents are expected to perform the skill of labour epidural insertion independently. This study illustrates that some residents may need as many as 75 attempts to ensure proficiency. Training programs could use cusum to track the progress of their residents' technical skills in order to guarantee an adequate experience.