The construction of learning curves for basic skills in anesthetic procedures: An application for the cumulative sum method
The construction of learning curves for basic skills in anesthetic procedures: An application for the cumulative sum method
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DOI：
10.1213/01.ane.0000021360.03491.b7
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发表时间：
2002-08-01
影响因子：
5.7
通讯作者：
de Oliveira, GR
中科院分区：
文献类型：
--
作者：
de Oliveira, GR
本研究旨在利用累积和法构建麻醉学基本操作技能的学习曲线。在前10个月的训练中，我们记录了1234次周围静脉插管，895次经口气管插管，688次脊椎插管和344次硬膜外硬膜外麻醉。每一步的学习曲线都是用累积法绘制的。计算在达到可接受的故障率之前所执行的程序的数量。所有住院医师在79-47次手术后均掌握了外周静脉插管技术。经43 33次手术后，7位住院医师中有4位在经口气管插管时失败率可接受。在36+/-20次手术后，11名住院医生中有7名在脊麻下获得了可接受的失败率。在硬膜外麻醉下，11名住院医生中有5名在21+/-11次手术后获得了可接受的失败率。在基本程序的学习阶段，累积方法是客观衡量绩效的有用工具。在达到可接受的失败率之前，需要执行的程序数量在个体之间存在很大的差异，这表明应该在个人的基础上跟踪执行情况。
This study aimed at constructing learning curves for basic procedural skills in anesthesiology using the cumulative sum method. We recorded 1234 peripheral venous cannulations, 895 orotracheal intubations, 688 spinals, and 344 epidurals performed by residents during the first 10 mo of training. Learning curves for each procedure were constructed by using the cusum method. The number of procedures performed until attainment of acceptable failure rates was calculated. All residents mastered peripheral venous cannulation after 79 47 procedures. Four of 7 residents attained acceptable failure rates at orotracheal intubation after 43 33 procedures. Seven of 11 residents attained acceptable failure rates at spinal anesthesia after 36 +/- 20 procedures. At epidural anesthesia, 5 of 11 residents attained acceptable failure rates after 21 +/- 11 procedures. The cusum method is a useful tool for objectively measuring performance during the learning phase of basic procedures. The wide interindividual variability in the number of procedures required to be performed before attaining acceptable failure rates suggests that performance should be followed on an individual basis.