Schüpfer G K, Konrad C, Poelaert J I
Institut für Anästhesie, chirurgische Intensivmedizin, Schmerztherapie und Rettungsmedizin, Kantonsspital, Lucerne, Switzerland.
Anaesthesist. 2003 Jun;52(6):527-34. doi: 10.1007/s00101-003-0509-8.
Assessment in anaesthesia traditionally takes the form of written papers and oral examinations. These are important for assessing trainee's knowledge and judgement, but do not test for competency in practical skills, which is essential for successful clinical practice. The presence of learning curves for practical skills in anaesthesia is now well recognized and they are useful tools to monitor a learning process. From these, estimates of the number of procedures that must be performed by trainees in order to reach an acceptable success rate can be produced. It is clear that these figures give some help for the rational design of training programs, however, numbers alone do not provide a sufficient basis to declare a trainee competent for a given procedure. Not only technical skills need to be taught, but also decision-making and even more important behavioral skills. In clinical practice there are often problems in providing all the necessary training on patients and by this reorganization of residency programs may be necessary. However, the role of medical simulation in the assessment of anesthetists in training is still unclear, and the introduction of simulator-based tests may be premature.
传统上，麻醉学评估采用书面考试和口试的形式。这些对于评估学员的知识和判断力很重要，但无法测试实践技能的能力，而实践技能对于成功的临床实践至关重要。麻醉实践技能存在学习曲线这一点现在已得到充分认可，它们是监测学习过程的有用工具。据此，可以得出学员为达到可接受的成功率必须执行的操作数量估计值。显然，这些数字有助于合理设计培训计划，然而，仅凭数字并不足以宣布学员具备执行特定操作的能力。不仅要教授技术技能，还要教授决策能力，甚至更重要的行为技能。在临床实践中，为患者提供所有必要培训往往存在问题，因此可能需要重新组织住院医师培训计划。然而，医学模拟在培训麻醉医师评估中的作用仍不明确，引入基于模拟器的测试可能为时过早。
