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[一项关于医学生对重症医学专业及重症监护病房的全国性调查]

[A national survey of medical students about the specialty of Intensive Medicine and intensive care units].

作者信息

Quintana Díaz M, Sánchez Casado M, López de Toro I, Hermoso Alarza F, García de Lorenzo A

机构信息

Servicio de Medicina Intensiva, Hospital Universitario La Paz, Madrid, Spain.

出版信息

Med Intensiva. 2009 Nov;33(8):363-9. doi: 10.1016/j.medin.2009.05.010. Epub 2009 Oct 3.

Abstract

OBJECTIVES

To determine the degree of knowledge about intensive medicine and interest in this specialty among medical students in Spain.

DESIGN

A survey with closed questions.

SETTING

Complutense University of Madrid, Autonomous University of Madrid, University of Salamanca, Autonomous University of Barcelona, University of Granada, and University of Alcalá de Henares.

PARTICIPANTS

Medical students from the above-mentioned universities.

RESULTS

A total of 377 medical students (mean age: 21.3+/-1.9 years) were included. Women made up 75.3% of the sample; 37.7% of the students surveyed were in their third year (of six total), and the rest were distributed equally among the other five years with the exception of the first year (1.6%). Most students (85.1%) stated that they studied medicine because they had a vocation for the profession, whereas 7.7% stated that they studied medicine because of the influence of their families. A total of 45.7% said they were making good grades and 16.7% needed to repeat some subjects. Students' knowledge of ICUs came from different sources: television (35%), personal experience (25.2%), and friends and/or family (35%); 16.4% had no knowledge of the ICU. ICUs were associated with intensivists in 86.5%. Most students said that ICUs treat patients with multiple trauma (85.4%), postoperative patients (68.4%), coronary patients (62.3%), respiratory patients (61.5%), and neurological patients (50.7%). The techniques that students considered were frequently employed in ICUs included mechanical ventilation (89.4%), orotracheal intubation (83.8%), intravenous sedation (71.1%), central venous lines (70.8%), intravenous analgesia (69.8%), nasogastric catheterization (63.9%), antibiotics (62.3%), total parenteral nutrition (56%), and tracheostomy (53.5%); less frequently mentioned were peripheral venous line placement (52.5%), temporary pacemaker placement (40.1%), arterial line placement (40.6%), Swan-Ganz catheterization (38.6%), intramuscular relaxation (32.4%), thoracocentesis (31,3%), continuous hemofiltration (28.9%), lumbar puncture (28.6%), and permanent pacemaker placement (19.7%). Students believe that intensivists participate in maintaining organ donors (70.6%) but little in detecting organ donors (40%) or in asking families for permission to extract organs (40.1%). Finally, 52% said that they will consider intensive medicine when specializing.

CONCLUSION

Although some aspects of intensive medicine are not well known among medical students, the general level of knowledge about intensive medicine is acceptable and more than half of the medical students surveyed will consider it when deciding on a specialty.

摘要

目的

确定西班牙医学生对重症医学的了解程度以及对该专业的兴趣。

设计

一项包含封闭式问题的调查。

地点

马德里康普顿斯大学、马德里自治大学、萨拉曼卡大学、巴塞罗那自治大学、格拉纳达大学和阿尔卡拉德埃纳雷斯大学。

参与者

上述大学的医学生。

结果

共纳入377名医学生(平均年龄:21.3±1.9岁)。女性占样本的75.3%;37.7%的受访学生处于六年制课程的第三年,其余学生在除第一年(1.6%)外的其他五年中分布均匀。大多数学生(85.1%)表示他们学医是因为对该职业有使命感,而7.7%的学生表示他们学医是受家庭影响。共有45.7%的学生表示成绩良好,16.7%的学生需要重修一些科目。学生对重症监护病房(ICU)的了解来自不同渠道:电视(35%)、个人经历(25.2%)以及朋友和/或家人(35%);16.4%的学生对ICU一无所知。86.5%的学生将ICU与重症医学专家联系在一起。大多数学生表示,ICU治疗多发性创伤患者(85.4%)、术后患者(68.4%)、冠心病患者(62.3%)、呼吸系统疾病患者(61.5%)和神经系统疾病患者(50.7%)。学生认为ICU经常使用的技术包括机械通气(89.4%)、经口气管插管(83.8%)、静脉镇静(71.1%)、中心静脉置管(70.8%)、静脉镇痛(69.8%)、鼻胃管插管(63.9%)、抗生素(62.3%)、全胃肠外营养(56%)和气管切开术(53.5%);较少被提及的有外周静脉置管(52.5%)、临时起搏器置入(40.1%)、动脉置管(40.6%)、 Swan-Ganz导管置入(38.6%)、肌肉松弛(32.4%)、胸腔穿刺术(31.3%)、连续性血液滤过(28.9%)、腰椎穿刺(28.6%)和永久性起搏器置入(19.7%)。学生认为重症医学专家参与维持器官捐献者(70.6%),但在识别器官捐献者(40%)或请求家属允许摘取器官(40.1%)方面参与较少。最后,52%的学生表示他们在选择专业时会考虑重症医学。

结论

尽管医学生对重症医学的某些方面了解不足,但对重症医学的总体了解水平尚可,超过一半的受访医学生在选择专业时会考虑该领域。

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