Stolarek Iwona
Hutt Valley District Health Board, Lower Hutt.
N Z Med J. 2007 May 4;120(1253):U2516.
To assess the impact of a simulation workshop prior to starting clinical work, on the practical and examination skills of first-year postgraduate house surgeons (PGY1s) starting at Hutt Hospital (Lower Hutt, New Zealand) and to compare this to 6 months of clinical ward experience alone.
Self-reporting questionnaires on clinical examination, and procedural skills were used to compare a 'control' group of 10 PGY1s who had 6 months on-the-ward training only, to a second 'intervention' group of 10 PGY1s who underwent training in a simulation skills workshop prior to starting clinical work.
The small numbers of PGY1s limit generalisation of the findings, however certain trends are evident. The skills workshop improved self-rated competence scores in clinical procedural skills, and was significant for lumbar punctures (LP) and spirometry. Scores were comparable to those of 6 months of clinical exposure alone. Self-reported confidence scores in picking up abnormalities of clinical examination improved in all areas taught and were significant for fundal, prostate, and rectal abnormalities. Scores exceeded those achieved with 6 months of clinical exposure.
The findings suggest that a skills workshop prior to starting clinical work may approximate 6 months of clinical experience and improve baseline procedural and examination skills.
评估在开始临床工作之前举办的模拟工作坊,对在新西兰下哈特市哈特医院入职的一年级住院医师(PGY1)的实践技能和考试技能的影响,并将其与仅6个月的临床病房经验进行比较。
使用关于临床检查和操作技能的自我报告问卷,将仅接受了6个月病房培训的10名PGY1组成的“对照组”,与在开始临床工作之前参加了模拟技能工作坊培训的10名PGY1组成的第二个“干预组”进行比较。
PGY1数量较少限制了研究结果的普遍性,不过某些趋势很明显。技能工作坊提高了临床操作技能的自评能力得分,在腰椎穿刺(LP)和肺活量测定方面具有显著性。得分与仅6个月临床接触的得分相当。在讲授的所有领域中,临床检查发现异常的自我报告信心得分均有所提高,在眼底、前列腺和直肠异常方面具有显著性。得分超过了6个月临床接触所取得的得分。
研究结果表明,在开始临床工作之前举办技能工作坊可能相当于6个月的临床经验,并提高基线操作和检查技能。