Deveau John P, Lorenz James E, Hughes Mary J
Michigan State University College of Osteopathic Medicine, USA.
J Am Osteopath Assoc. 2003 Jun;103(6):291-6.
The purpose of this study was to assess procedural accomplishment, work productivity, and efficiency for emergency medicine residents in a community-based, osteopathic emergency medicine residency. These data are compared with limited existing data from other training sites. The authors conducted a retrospective analysis of patient-encounter data logged into a computerized main-frame database over 8 years by 19 resident physicians. Only data from residents who had complete logs for all 3 years of residency were included. Procedures and diagnoses were from the core content areas defined in the basic standards for approval of residency training programs in emergency medicine. Approximately 98,000 patient encounters were logged during the study period. First-year emergency medicine residents saw an average of 1.06 patients per hour, second-year emergency medicine residents an average of 1.33 patients per hour, and third-year emergency medicine residents an average of 1.41 patients per hour. Residents performed an average of 65 intubations, 533 adult resuscitations, 144 pediatric resuscitations, 49 central line insertions, 47 lumbar punctures, and 280 laceration repairs. Residents tend to see more patients per hour as their training progresses. Residents in this program get significant experience in some procedures but little or no clinical exposure to other procedures. These results are consistent with the few other published reports attempting to quantify the emergency medicine resident experience. The data may assist in setting clinical objectives and establishing uniform tracking systems and coding terminology.
本研究的目的是评估在以社区为基础的整骨疗法急诊医学住院医师培训项目中，急诊医学住院医师的操作完成情况、工作效率和效能。这些数据与其他培训地点有限的现有数据进行了比较。作者对19名住院医师在8年期间录入计算机主机数据库的患者诊疗数据进行了回顾性分析。仅纳入了在住院医师培训的全部3年都有完整记录的住院医师的数据。操作和诊断来自急诊医学住院医师培训项目批准基本标准中定义的核心内容领域。在研究期间记录了约98,000次患者诊疗。急诊医学一年级住院医师平均每小时诊治1.06名患者，二年级住院医师平均每小时诊治1.33名患者，三年级住院医师平均每小时诊治1.41名患者。住院医师平均进行了65次插管、533次成人复苏、144次儿科复苏、49次中心静脉置管、47次腰椎穿刺和280次伤口缝合。随着培训的推进，住院医师每小时诊治的患者往往更多。该项目的住院医师在某些操作方面获得了丰富经验，但在其他操作方面几乎没有或没有临床接触。这些结果与其他少数试图量化急诊医学住院医师经历的已发表报告一致。这些数据可能有助于设定临床目标、建立统一的跟踪系统和编码术语。
