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医学实习生的患者安全知识及其决定因素。

Patient safety knowledge and its determinants in medical trainees.

作者信息

Kerfoot B Price, Conlin Paul R, Travison Thomas, McMahon Graham T

机构信息

Veterans Affairs Boston Healthcare System, 150 South Huntington Avenue, 151DIA, Jamaica Plain, Boston, MA 02130, USA.

出版信息

J Gen Intern Med. 2007 Aug;22(8):1150-4. doi: 10.1007/s11606-007-0247-8. Epub 2007 Jun 6.

Abstract

BACKGROUND

Patient safety is a core educational topic for medical trainees.

OBJECTIVES

To determine the current level and determinants of patient safety knowledge in medical trainees.

DESIGN

Multi-institutional cross-sectional assessment of patient safety knowledge.

PARTICIPANTS

Residents and medical students from seven Harvard-affiliated residencies and two Harvard Medical School courses.

MEASUREMENTS

Participants were administered a 14-item validated test instrument developed based on the patient safety curriculum of the Risk Management Foundation (Cambridge, MA). The primary outcome measure was the amount of patient safety knowledge demonstrated by trainees on the validated test instrument. The secondary outcome measure was their subjective perceptions as to their baseline knowledge level in this domain.

RESULTS

Ninety-two percent (640/693) of residents and medical students completed the patient safety test. Participants correctly answered a mean 58.4% of test items (SD 15.5%). Univariate analyses show that patient safety knowledge levels varied significantly by year of training (p = 0.001), degree program (p < 0.001), specialty (p < 0.001), country of medical school (p = 0.006), age (p < 0.001), and gender (p = 0.050); all but the latter two determinants remained statistically significant in multivariate models. In addition, trainees were unable to assess their own knowledge deficiencies in this domain.

CONCLUSIONS

Patient safety knowledge is limited among medical trainees across a broad range of training levels, degrees, and specialties. Effective educational interventions that target deficiencies in patient safety knowledge are greatly needed.

摘要

背景

患者安全是医学实习生的核心教育主题。

目的

确定医学实习生患者安全知识的当前水平及其决定因素。

设计

对患者安全知识进行多机构横断面评估。

参与者

来自七所哈佛附属住院医师培训项目和两门哈佛医学院课程的住院医师和医学生。

测量方法

向参与者发放一份基于风险管理基金会(马萨诸塞州剑桥)患者安全课程开发的、经过验证的14项测试工具。主要结局指标是实习生在经过验证的测试工具上展示的患者安全知识量。次要结局指标是他们对自己在该领域基线知识水平的主观认知。

结果

92%(640/693)的住院医师和医学生完成了患者安全测试。参与者正确回答的测试项目平均为58.4%(标准差15.5%)。单因素分析表明,患者安全知识水平因培训年份(p = 0.001)、学位项目(p < 0.001)、专业(p < 0.001)、医学院所在国家(p = 0.006)、年龄(p < 0.001)和性别(p = 0.050)而有显著差异;除了后两个决定因素外,其他因素在多变量模型中仍具有统计学意义。此外,实习生无法评估自己在该领域的知识缺陷。

结论

在广泛的培训水平、学位和专业的医学实习生中,患者安全知识有限。非常需要针对患者安全知识缺陷的有效教育干预措施。

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