Assessing pediatric senior residents' training in resuscitation: Fund of knowledge, technical skills, and perception of confidence
Assessing pediatric senior residents' training in resuscitation: Fund of knowledge, technical skills, and perception of confidence
复制标题
DOI：
10.1097/00006565-200004000-00001
复制
发表时间：
2000-04-01
影响因子：
1.4
通讯作者：
Durbin, DR
中科院分区：
文献类型：
--
作者：
Nadel, FM;Lavelle, JM;Durbin, DR
目的：描述儿科住院医师的知识、经验、对儿科复苏的信心以及他们在日常培训期间执行重要复苏程序的能力。设计和参与者：在大型三级护理儿童医院参加 ACGME 认可的儿科住院医师培训计划的 PGY-3 级住院医师的队列研究。方法：通过儿科标准化测试来评估知识储备 高级生命支持 BALS）课程以及需要临床解决问题技能的补充简答测试。通过观察住院医师在技能研讨会期间使用加权逐步评分表执行四项程序来评估程序技能。通过匿名调查对居民的体验和信心进行了量化。结果：97% 的居民参与了。住院医生在标准化 PALS 测试中取得了高分 (93.2% +/- 5.5)，但在简答测试中回答更复杂的问题 (60.0% +/- 9.9) 时表现较差。没有住院医师能够成功执行基本和高级气道技能，只有 11% 的患者成功完成这两项血管技能。尽管居民对自己的复苏技能总体上有信心，但技能研讨会上的表现却显示出明显的缺陷。例如，只有 18% 的人正确执行了辅助气道操作。没有一个居民正确地执行了所有四项技能。真实和模拟复苏的经验并不多见。居民表示，只有不到一半的时间收到有关其表现的反馈。超过89%的人认为复苏知识和技能对他们未来选择的职业很重要。结论：儿科住院医师很少领导或参与真实或模拟复苏。尽管对执行许多必要的复苏技能充满信心，但很少有居民能够正确执行这些技能的关键组成部分。目前的儿科住院医师培训可能无法提供足够的经验来培养复苏所需的足够技能、知识储备或信心。
Objective: To describe pediatric housestaff knowledge, experience, confidence in pediatric resuscitations and their ability to perform important resuscitation procedures during the usual training experience.Design and participants: Cohort study of PGY-3 level residents in a ACGME accredited pediatric residency training program at a large, tertiary care children's hospital.Methods: Fund of knowledge was assessed by administering the standardized test from the Pediatric Advanced Life Support BALS) Course in addition to a supplemental short answer test requiring clinical problem-solving skills. Procedural skills were evaluated through observation of the resident performing four procedures during a skills workshop using a weighted step-wise grading sheet. Resident experience and confidence was quantified using an anonymous survey.Results: Ninety-seven percent of residents participated. Residents achieved high scores on the standardized PALS test (93.2% +/- 5.5), but performed less well when answering more complicated questions (60.0% +/- 9.9) on the short answer test. No resident was able to successfully perform both basic and advanced airway skills, and only 11% successfully completed both vascular skills. Although residents mere overall confident in their resuscitation skills, performance in the skill workshop revealed significant deficits. For example, only 18% performed ancillary airway maneuvers properly. None of the residents performed all four skills correctly. Experience in both real and mock resuscitations was infrequent. Residents reported receiving feedback on their performance less than half of the time. Over 89% of them felt that resuscitation knowledge and skill were important for their future chosen career.Conclusion: Pediatric residents infrequently lead or participate in real or mock resuscitations. Although confident in performing many of the necessary resuscitation skills, few residents performed critical components of these skills correctly. Current pediatric residency training may not provide sufficient experience to develop adequate skills, fund of knowledge, or confidence needed for resuscitation.