Brookdale Department of Geriatrics and Palliative Care, Mount Sinai School of Medicine, New York, New York, USA.
J Palliat Med. 2011 May;14(5):548-55. doi: 10.1089/jpm.2010.0343. Epub 2011 Feb 3.
To characterize the level of formal training and perceived educational needs in palliative care of emergency medicine (EM) residents.
This descriptive study used a 16-question survey administered at weekly resident didactic sessions in 2008 to EM residency programs in New York City. Survey items asked residents to: (1) respond to Likert-scaled statements about the role of palliative care in the emergency department (ED); (2) quantify their level of formal training and personal comfort in symptom management, discussion of bad news and prognosis, legal issues, and withdrawing/withholding therapy; and (3) express their interest in future palliative care training.
Of 228 total residents, 159 (70%) completed the survey. Of those surveyed, 50% completed some palliative care training before residency; 71.1% agreed or strongly agreed that palliative care was an important competence for an EM physician. However, only 24.3% reported having a "clear idea of the role of palliative care in EM." The highest self-reported level of formal training was in the area of advanced directives or legal issues at the end of life; the lowest levels were in areas of patient management at the end of life. The highest level of self-reported comfort was in giving bad news and the lowest was in withholding/withdrawing therapy. A slight majority of residents (54%) showed positive interest in receiving future training in palliative care.
New York City EM residents reported palliative care as an important competency for emergency medicine physicians, yet also reported low levels of formal training in palliative care. The majority of residents surveyed favored additional training.
描述急诊医学（EM）住院医师在姑息治疗方面的正规培训水平和感知到的教育需求。
这项描述性研究使用了 2008 年在纽约市 EM 住院医师培训计划每周的住院医师理论课程中进行的 16 个问题的调查。调查项目要求住院医师：（1）对姑息治疗在急诊科的作用的陈述做出 Likert 量表式的回答；（2）量化他们在症状管理、讨论坏消息和预后、法律问题以及撤回/停止治疗方面的正规培训水平和个人舒适度；（3）表达他们对未来姑息治疗培训的兴趣。
在 228 名住院医师中，有 159 名（70%）完成了调查。在接受调查的人员中，有 50%的人在住院前完成了一些姑息治疗培训；71.1%的人同意或强烈同意姑息治疗是急诊医师的一项重要能力。然而，只有 24.3%的人报告说对姑息治疗在 EM 中的作用“有明确的认识”。自我报告的正规培训水平最高的领域是在生命末期的高级指令或法律问题；最低的领域是在生命末期的患者管理。自我报告的舒适度最高的是告知坏消息，最低的是拒绝/撤回治疗。略多于一半的住院医师（54%）对接受未来姑息治疗培训表现出积极的兴趣。
纽约市 EM 住院医师报告说姑息治疗是急诊医师的一项重要能力，但也报告说在姑息治疗方面的正规培训水平较低。大多数接受调查的住院医师都赞成增加培训。
