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[德国大学医院的麻醉学教育:教师视角——一项全国性调查的结果]

[Anaesthesia education at german university hospitals: the teachers' perspective -- results of a nationwide survey].

作者信息

Goldmann K, Steinfeldt T, Wulf H

机构信息

Klinik für Anästhesie und Intensivtherapie, Philipps Universität Marburg.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2006 Apr;41(4):204-9; quiz 210-2. doi: 10.1055/s-2006-925367.

Abstract

AIM OF THIS STUDY

The principle purpose of this study was to collect data on the conditions and practice of anaesthesia education as well as the teaching qualification of consultants at German university hospitals. Based upon the collected data, areas of weakness and strength as well as measures required to improve anaesthesia training are described.

METHODS

A questionnaire containing 26 items was mailed to 607 consultants employed at 41 German university hospitals in June 2003.

RESULTS

A total of 255 questionnaires was analysed (response rate: 43 %). Genuine training activities account for 14 % of the working hours of the participating consultants. On average, at the institutions of participating consultants, novices work for a duration of 1 month together with a consultant anaesthetist before they give anaesthetics without direct and constant supervision. When asked to describe the predominant method of training at their institution 71 % indicated "case-oriented teaching"; however, 53 % chose "see one, do one, teach one" and 49 % "learning by doing" as method of training as well (multiple choice). According to 63 % of respondents, departmental educational activities usually happen after their regular working hours. "Daily workload" (96 %), "time pressure" (96 %), "lack of time" (96 %) and "lack of personnel" (90 %) were indicated as the main obstacles of teaching. According to 80 % of respondents, a dedicated financial budget for education does not exist; instead, financial resources of third parties (industry) (58 %), of the state (for research und undergraduate education) (60 %) and of patients service (66 %) are used to ensure training of anaesthesia residents.

CONCLUSION

Due to a lack of a dedicated financial budget for resident training and an increasing economic pressure, "lack of time" and "lack of personnel" are the main factors leading to the situation at German university hospitals that consultants can only spend 14 % of their working hours for teaching purposes despite of sufficient qualification and motivation. As a consequence, novice anaesthetists are faced with the situation to be working without direct and constant supervision after 1 month of training.

摘要

本研究目的

本研究的主要目的是收集有关德国大学医院麻醉学教育状况与实践以及顾问医生教学资质的数据。基于所收集的数据,阐述麻醉学培训的薄弱环节与优势以及改进所需采取的措施。

方法

2003年6月,向德国41所大学医院聘用的607位顾问医生邮寄了一份包含26个项目的调查问卷。

结果

共分析了255份调查问卷(回复率:43%)。实际培训活动占参与调查的顾问医生工作时间的14%。平均而言,在参与调查的顾问医生所在机构,新手在无直接持续监督下实施麻醉前,要与麻醉顾问医生一起工作1个月。当被要求描述其所在机构的主要培训方法时,71%的人表示是“以病例为导向的教学”;然而,53%的人也选择“看一例,做一例,教一例”,49%的人选择“边做边学”作为培训方法(多项选择)。63%的受访者表示,科室教育活动通常在正常工作时间之后进行。“日常工作量”(96%)、“时间压力”(96%)、“时间不足”(96%)和“人员短缺”(90%)被指出是教学的主要障碍。80%的受访者表示不存在专门的教育预算;相反,第三方(行业)(58%)、国家(用于研究和本科教育)(60%)以及患者服务(66%)的财政资源被用于确保麻醉住院医生的培训。

结论

由于缺乏专门用于住院医生培训的财政预算以及经济压力不断增加,“时间不足”和“人员短缺”是导致德国大学医院出现这种情况的主要因素,即尽管顾问医生具备足够资质和积极性,但他们只能将14%的工作时间用于教学目的。因此,麻醉新手在培训1个月后就面临在无直接持续监督的情况下工作的局面。

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