Bouchacourt J P, Castromán P
Departamento y Cátedra de Anestesiología, Hospital de Clínicas, Facultad de Medicina de la Universidad de la República, Montevideo, Uruguay.
Rev Esp Anestesiol Reanim. 2007 Jun-Jul;54(6):349-54.
Orotracheal intubation is one of the first techniques a new resident learns. The cumulative sum (cusum) method has been shown to be a useful tool for the assessment of learning, as it provides qualitative and quantitative information that allows technical competence to be certified. The aim of this study was to use the cusum method to assess the learning of orotracheal intubation by a group of first year residents.
The residents were evaluated at 2 stages. In the first, the acceptable failure rate was set at 10% and in the second it was reduced to 5%. Learning curves were constructed for each resident for both stages.
Eight residents were evaluated. They performed 868 intubations, 330 at the first stage and 538 at the second. Forty (4.6%) of the intubations failed: 26 (7.9%) in the first stage and 14 (2.6%) in the second. All residents achieved the acceptable failure rate of 10% in the first 3 months with a mean (SD) number of intubations of 41.3 (6). All achieved the 5% acceptable failure rate within the 11 months of study, after a mean of 67.3 (28) intubations.
The cusum method proved a useful tool for training residents to perform tracheal intubation. It afforded objective information on performance and facilitated evaluation while learning was taking place.
经口气管插管是新住院医师首先学习的技术之一。累积和(cusum)法已被证明是一种评估学习情况的有用工具,因为它提供了定性和定量信息,可用于认证技术能力。本研究的目的是使用cusum法评估一组一年级住院医师经口气管插管的学习情况。
在两个阶段对住院医师进行评估。第一阶段,可接受的失败率设定为10%,第二阶段降至5%。为每个住院医师构建两个阶段的学习曲线。
对8名住院医师进行了评估。他们共进行了868次插管,第一阶段330次,第二阶段538次。40次(4.6%)插管失败:第一阶段26次(7.9%),第二阶段14次(2.6%)。所有住院医师在头3个月内均达到了10%的可接受失败率,平均(标准差)插管次数为41.3(6)次。在平均进行67.3(28)次插管后,所有住院医师在11个月的研究期内均达到了5%的可接受失败率。
cusum法被证明是培训住院医师进行气管插管的有用工具。它提供了关于操作表现的客观信息,并在学习过程中便于进行评估。