Clayton R A E, Henderson J, McCracken S E, Wigmore S J, Paterson-Brown S
Department of Orthopaedic Surgery, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK.
Postgrad Med J. 2005 Jun;81(956):396-400. doi: 10.1136/pgmj.2004.024190.
To assess the experience gained by pre-registration house officers (PRHOs) at the end of their first post. To assess confidence in managing common emergencies and experience gained in practical procedures. To compare traditional six month posts with four month posts and to compare the experiences of PRHOs posted in teaching hospitals (THs) with those based in district general hospitals (DGHs).
Interview questionnaire.
152 graduates from Edinburgh University Medical School in 2000 who had completed their first PRHO post by February 2001.
There were few significant differences in confidence in managing emergencies and in numbers of practical procedures attempted between respondents from four and six month posts or between those holding TH and DGH posts. PRHOs had gained little experience in practical procedures: fewer than 15% had performed five or more of a number of procedures including lumbar puncture, pleural aspiration, chest drainage, and insertion of nasogastric tube. A high proportion of PRHOs indicated that they felt confident initiating management of conditions in specialties of which they had little or no experience.
Rotations of three four month posts do not seem to reduce overall experience in the PRHO year. There is little difference in experience gained between TH and DGH posts. PRHOs perform few practical procedures and some may be overconfident in their own abilities.
评估预注册住院医师(PRHO)在其首个岗位结束时所获得的经验。评估处理常见急症的信心以及在实际操作中获得的经验。比较传统的六个月岗位与四个月岗位,并比较在教学医院(TH)工作的PRHO与在区综合医院(DGH)工作的PRHO的经验。
访谈问卷。
2000年毕业于爱丁堡大学医学院且截至2001年2月已完成首个PRHO岗位工作的152名毕业生。
在处理急症的信心方面,以及在四个月岗位和六个月岗位的受访者之间,或在教学医院岗位和区综合医院岗位的受访者之间,尝试的实际操作数量上,几乎没有显著差异。PRHO在实际操作方面获得的经验很少:包括腰椎穿刺、胸腔穿刺、胸腔引流和鼻胃管插入等多项操作中,不到15%的人进行过五项或更多操作。很大一部分PRHO表示,他们对在自己几乎没有或完全没有经验的专科中启动病情管理感到有信心。
三个四个月岗位的轮转似乎不会减少PRHO年度的总体经验。教学医院岗位和区综合医院岗位获得的经验几乎没有差异。PRHO进行的实际操作很少,而且有些人可能对自己的能力过于自信。