The effect of simulation-based mastery learning on thoracentesis referral patterns.
The effect of simulation-based mastery learning on thoracentesis referral patterns.
复制标题
基于模拟的掌握学习对胸腔穿刺转诊模式的影响。
DOI：
10.1002/jhm.2623
复制
发表时间：
2016
影响因子：
2.6
通讯作者：
Wayne,DianeB
中科院分区：
文献类型：
--
作者：
Barsuk,JeffreyH;Cohen,ElaineR;Williams,MarkV;Scher,Jordan;Feinglass,Joe;McGaghie,WilliamC;O'Hara,Kelly;Wayne,DianeB
内科（IM）居民和住院医师通常进行胸腔穿刺术。国家数据显示，胸腔穿刺术也经常被转介到其他服务，如介入放射学，增加了医疗保健费用。基于模拟的掌握学习（SBML）是提高医生程序技能和自信心的有效方法。本研究旨在（1）评估SBML对IM住院医师模拟胸腔穿刺术技能的影响，（2）比较传统培训的住院医师（未接受SBML培训）、接受SBML培训的住院医师和住院医师之间的胸腔穿刺术转诊模式、自信心和转诊原因。从2012年12月至2015年5月，在一家学术医疗中心随机抽取112名IM居民完成了SBML胸腔穿刺术。我们调查了同一时期内护理住院胸腔穿刺患者的医生，并比较了转诊模式，自信心和转诊原因。SBML培训的住院医师胸腔穿刺术技能从试验前的中位数57.6%（四分位距[IQR] 43.3-76.9）提高到试验后的96.2%（IQR 96.2-100.0）（P< 0.001）。调查表明，传统的培训居民更有可能提到IR，并引用较低的信心作为原因。接受SBML培训的住院医师更有可能进行床边胸腔穿刺术。住院医生最有可能参考肺部医学，并指出缺乏时间进行手术是主要原因。接受SBML培训的住院医生对自己的胸腔穿刺术技能最有信心，尽管住院医生有更多的经验。这项研究确定了信心和时间的原因，医生提到胸腔穿刺术，而不是在床边进行。胸腔穿刺SBML提高技能，促进床边程序，安全且比转诊便宜。医院医学杂志2016;11：792-795。© 2016医院医学学会
Internal medicine (IM) residents and hospitalist physicians commonly perform thoracenteses. National data show that thoracenteses are also frequently referred to other services such as interventional radiology (IR), increasing healthcare costs. Simulation‐based mastery learning (SBML) is an effective method to boost physicians' procedural skills and self‐confidence. This study aimed to (1) assess the effect of SBML on IM residents' simulated thoracentesis skills and (2) compare thoracentesis referral patterns, self‐confidence, and reasons for referral between traditionally trained residents (non–SBML‐trained), SBML‐trained residents, and hospitalist physicians. A random sample of 112 IM residents at an academic medical center completed thoracentesis SBML from December 2012 to May 2015. We surveyed physicians caring for hospitalized patients with thoracenteses during the same time period and compared referral patterns, self‐confidence, and reasons for referral. SBML‐trained resident thoracentesis skills improved from a median of 57.6% (interquartile range [IQR] 43.3–76.9) at pretest to 96.2% (IQR 96.2–100.0) at post‐test (P< 0.001). Surveys demonstrated that traditionally trained residents were more likely to refer to IR and cited lower confidence as reasons. SBML‐trained residents were more likely to perform bedside thoracenteses. Hospitalist physicians were most likely to refer to pulmonary medicine and cited lack of time to perform the procedure as the main reason. SBML‐trained residents were most confident about their thoracentesis skills, despite hospitalist physicians having more experience. This study identifies confidence and time as reasons physicians refer thoracenteses rather than perform them at the bedside. Thoracentesis SBML boosts skills and promotes bedside procedures that are safe and less expensive than referrals.Journal of Hospital Medicine2016;11:792–795. © 2016 Society of Hospital Medicine
登录
查看更多内容
在大学医院进行腹腔穿刺术的专业：对培训和认证的影响。
影响因子：
2.6
作者：
J. Barsuk;J. Feinglass;S. Kozmic;S. Hohmann;D. Ganger;D. Wayne
通讯作者：
D. Wayne
影响因子：
2.6
作者：
Dressier, Daniel D.;Pistoria, Michael J.;Amin, Alpesh N.
通讯作者：
Amin, Alpesh N.
DOI：
10.1016/s1553-7250(16)42004-0
发表时间：
2016-01-01
影响因子：
2.3
作者：
Kozmic, Sarah E.;Wayne, Diane B.;Barsuk, Jeffrey H.
通讯作者：
Barsuk, Jeffrey H.
经过模拟教育后在床边进行穿刺手术可节省成本
DOI：
--
发表时间：
2014
期刊：
Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare
影响因子：
--
作者：
J. Barsuk;E. Cohen;J. Feinglass;S. Kozmic;W. McGaghie;D. Ganger;D. Wayne
通讯作者：
D. Wayne
影响住院医师侵入性床边手术表现的因素
DOI：
10.5455/jcme.20150630101951
发表时间：
2015
期刊：
Journal of Contemporary Medical Education
影响因子：
--
作者：
Cynthia Kay;A. Szabo;J. Jackson
通讯作者：
J. Jackson