Smith L F
Department of Epidemiology and Public Health Medicine, University of Bristol.
BMJ. 1991 Dec 7;303(6815):1447-50. doi: 10.1136/bmj.303.6815.1447.
To examine the content of hospital obstetric vocational training for general practice, the beliefs of general practitioner trainees about this training, and their perceived competence at practical obstetric procedures and the effect of training.
Confidential postal questionnaire.
A random one in four sample of all general practitioner trainees in the United Kingdom on vocational training schemes or in training practices in Autumn 1990.
Trainees' competence and beliefs on Likert scale, numbers of procedures witnessed and performed, type of maternity care trainees intended to provide.
Of 1019 trainees sent questionnaires, 765 (75.1%) replied; 517 had done some hospital obstetric training. After six months as a senior house officer 232/367 (63%) believed they were competent to perform a normal delivery unaided, 228 (62%) to manage a severe postpartum haemorrhage, and 227 (62%) to resuscitate a newborn infant. 272 (35.6%) trainees intended to provide intrapartum care and 56 (7.5%) to book home deliveries in the future. Hospital training increased confidence in performing most obstetric procedures in all trainees. However, a greater proportion of trainees who intended to provide full care than shared care felt competent at performing a normal vaginal delivery (63% (170/272) full v 45% (215/473) shared), low forceps delivery (38% (103) v 17% (79)), manual removal of placenta (24% (65) v 17% (82)), and intubating a neonate (42% (114) v 34% (161)). Trainees who had done any obstetric training were less likely to think that training encouraged future provision of intrapartum care (113/509 (22%) training v 65/213 (31%) no training).
Hospital vocational obstetric training increases the perceived competence of trainees but fails to encourage them to use obstetric skills.
研究医院产科职业培训的全科医学内容、全科医生培训学员对该培训的看法、他们在产科实际操作中的感知能力以及培训效果。
保密邮寄问卷调查。
1990年秋季在联合王国参与职业培训计划或培训实习的所有全科医生培训学员中,随机抽取四分之一的样本。
学员在李克特量表上的能力和看法、所见证和执行的操作数量、学员打算提供的产科护理类型。
在1019名收到问卷的学员中,765名(75.1%)回复;517名接受过一些医院产科培训。在担任高级住院医师六个月后,232/367(63%)的学员认为自己有能力独立进行正常分娩,228名(62%)认为有能力处理严重产后出血,227名(62%)认为有能力复苏新生儿。272名(35.6%)学员打算提供产时护理,56名(7.5%)学员打算未来负责家庭分娩。医院培训提高了所有学员在执行大多数产科操作方面的信心。然而,打算提供全程护理的学员比提供共享护理的学员中,有更大比例的人认为自己有能力进行正常阴道分娩(63%(170/272)全程护理对45%(215/473)共享护理)、低位产钳分娩(38%(103)对17%(79))、徒手剥离胎盘(24%(65)对17%(82))以及给新生儿插管(42%(114)对34%(161))。接受过任何产科培训的学员不太可能认为培训鼓励未来提供产时护理(113/509(22%)接受培训对65/213(31%)未接受培训)。
医院产科职业培训提高了学员的感知能力,但未能鼓励他们运用产科技能。