Tabas Jeffrey A, Rosenson Jon, Price Daniel D, Rohde Dana, Baird Carina H, Dhillon Nripendra
Department of Medicine, University of California, San Francisco, CA, USA.
Acad Emerg Med. 2005 Aug;12(8):782-5. doi: 10.1197/j.aem.2005.04.004.
Preparing medical students for residency in emergency medicine involves education in many areas of knowledge and skill, including instruction in advanced emergency procedures.
To outline the logistics involved in running a training course in advanced emergency procedures for fourth-year medical students and to report students' perceptions of the impact of the course.
The course is a cadaver-based training laboratory that utilizes several teaching modalities, including a Web-based syllabus and online streaming video, didactic lecture, hands-on practice with models and ultrasound, and hands-on practice with unembalmed (fresh) cadavers. The course focuses on seven emergent procedural skills, including deep venous access via the subclavian, internal jugular, and femoral veins; tube thoracostomy; saphenous vein cutdown; intraosseous line placement; and emergency cricothyrotomy. The course is taught by attending emergency physicians and anatomy department faculty. After completion of the course, students reported their self-assessments on a five-point Likert scale. Data were evaluated using a paired t-test (two-tailed).
Thirty-three students completed the evaluation. The students reported a mean (+/- standard deviation [SD]) increase in their understanding of the indications for all procedures from 3.3 (+/- 1.1) before to 4.8 (+/- 0.4) after the course (p = 0.004, 95% CI = 0.7 to 2.0). The students reported a mean increase in their understanding of how to perform all procedures from 2.1 (+/- 0.9) before to 4.6 (+/- 0.6) after the course (p = 0.003, 95% CI = 1.9 to 3.0). The students reported a mean increase in their comfort level performing all procedures from 1.6 (+/- 0.8) before to 4.2 (+/- 0.7) after the course (p < 0.001, 95% CI = 2.0 to 2.9).
These findings support the value of an advanced emergency procedural training course using an unembalmed cadaver-based laboratory and incorporating several teaching modalities.
让医学生为急诊医学住院医师培训做好准备涉及多个知识和技能领域的教育，包括高级急救程序的教学。
概述为四年级医学生开展高级急救程序培训课程所涉及的后勤工作，并报告学生对该课程影响的看法。
该课程是一个基于尸体的培训实验室，采用多种教学方式，包括基于网络的教学大纲和在线流媒体视频、理论讲座、使用模型和超声的实践操作，以及使用未防腐（新鲜）尸体的实践操作。该课程重点关注七种紧急程序技能，包括经锁骨下静脉、颈内静脉和股静脉进行深静脉穿刺；胸腔闭式引流术；大隐静脉切开术；骨髓腔内输液；以及紧急环甲膜切开术。该课程由急诊内科医生和解剖学系教员授课。课程结束后，学生用五点李克特量表报告他们的自我评估。数据采用配对t检验（双侧）进行评估。
33名学生完成了评估。学生报告称，他们对所有程序适应症的理解平均（±标准差[SD]）从课程前的3.3（±1.1）提高到课程后的4.8（±0.4）（p = 0.004，95%置信区间 = 0.7至2.0）。学生报告称，他们对如何执行所有程序的理解平均从课程前的2.1（±0.9）提高到课程后的4.6（±0.6）（p = 0.003，95%置信区间 = 1.9至3.0）。学生报告称，他们执行所有程序的舒适度平均从课程前的1.6（±0.8）提高到课程后的4.2（±0.7）（p < 0.001，95%置信区间 = 2.0至2.9）。
这些发现支持了使用基于未防腐尸体的实验室并结合多种教学方式的高级急救程序培训课程的价值。
