Roy Amy Doolan, Chen Lei, Santucci Karen
Section of Emergency Medicine, The Elliot Hospital, Manchester, NH 03103, USA.
Pediatr Emerg Care. 2011 Jul;27(7):586-90. doi: 10.1097/PEC.0b013e31822251fb.
The objective was to assess pediatric residents' attitudes toward and knowledge about medical malpractice before and after an educational intervention.
A survey of pediatric residents at our academic tertiary-care center was conducted before and 6 months after an educational workshop.
Of 71 eligible residents, 46 (65%) completed surveys. Thirty-nine (85%) of the 46 original participants completed the follow-up survey. At baseline, 86% thought medical malpractice should be taught during residency. This proportion increased to 95% at follow-up. At baseline, 43% reported that fear of a malpractice claim affected their practice. At follow-up, 69% indicated that fear of malpractice affected their practice (P = 0.01), and 69% of these reported improved documentation. At baseline, 30% of participants correctly thought that a resident's level of training was not a factor in determining if standard of care was provided. This increased to 56% at follow-up (P = 0.01). The majority (91%) of baseline participants thought a physician would be notified of a claim within less than 2 years of the occurrence. The actual mean delay is 25 months. At follow-up, 71% thought a physician would be notified 2 years later or more.
Pediatric residents are uncomfortable with their knowledge of medical malpractice and think it should be taught during residency. Confusion regarding responsibility to provide standard of care and underestimates of the likelihood of being sued and the time to notification of a suit support the need for malpractice education. An educational intervention improves background knowledge and self-reported documentation.
评估教育干预前后儿科住院医师对医疗事故的态度和知识。
在我们的学术三级医疗中心,于教育研讨会前和会后6个月对儿科住院医师进行了一项调查。
71名符合条件的住院医师中,46名(65%)完成了调查。46名原始参与者中有39名(85%)完成了随访调查。基线时,86%的人认为住院期间应教授医疗事故相关内容。随访时这一比例增至95%。基线时,43%的人报告称担心医疗事故索赔会影响他们的医疗行为。随访时,69%的人表示担心医疗事故会影响他们的医疗行为(P = 0.01),其中69%的人报告称病历记录有所改善。基线时,30%的参与者正确认为住院医师的培训水平不是决定是否提供了标准医疗护理的因素。随访时这一比例增至56%(P = 0.01)。大多数(91%)基线参与者认为医生会在事件发生后不到2年内接到索赔通知。实际平均延迟时间为25个月。随访时,71%的人认为医生会在两年后或更久接到通知。
儿科住院医师对自己关于医疗事故的知识不满意,并认为住院期间应教授相关内容。在提供标准医疗护理的责任方面存在困惑,对被起诉的可能性以及接到诉讼通知的时间估计不足,这些都表明需要进行医疗事故教育。一项教育干预改善了背景知识和自我报告的病历记录。