Goldman Ran D, Cheng Adam, Jarvis Anna, Keogh Kelly, Lu Guo-ping, Wang Jian-she, Kissoon Niranjan, Larson Charles
Division of Pediatric Emergency Medicine, BC Children's Hospital, Vancouver, British Columbia, Canada.
Pediatr Emerg Care. 2011 Dec;27(12):1208-12. doi: 10.1097/PEC.0b013e31823ecea3.
The health care system reform in the People's Republic of China has brought plans for establishment of a universal coverage for basic health services, including services for children. This effort demands significant change in health care planning. Pediatric emergency medicine (PEM) is not currently identified as a specialty in China, and emergency medicine systems suffer from lack of appropriate training.In 2006, the Centre for International Child Health and the Department of Pediatrics, British Columbia Children's Hospital, Vancouver, Canada, initiated a fellowship training program in PEM for pediatricians working in emergency departments or critical care settings with the Children's Hospital of Fudan University, China. The main objective was to upgrade the professional and clinical experience of emergency physicians practicing PEM and build PEM capacity throughout China by training the future trainers.
After selecting trainees, the program included a structured curriculum over 2 years of training in China by Canadian and Australian PEM faculty and then practical exposure to PEM in Canada. All trainees underwent a structured evaluation after their final rotation in Canada.
A total of 12 trainees completed the first 2 program cycles. The trainees considered the "overall rating of the training experience" as "excellent" (10/12) or "good" (2/12). All trainees considered the program as a relevant training to their practice and felt it will change their practice. They reported the program to be effective, with excellent complexity of content.
Despite its current success, the program faces challenges in the development of the new subspecialty and ensuring its acceptance among other health care providers and decision makers. Identification and preparation of a capable training force to lead educational activities in China are daunting tasks. Time constraints, funding, and language barriers are other challenges. Future effort should be focused on improving and sustaining resuscitation capacity and enhancing triage systems.
中华人民共和国的医疗体系改革带来了建立全民基本医疗服务覆盖计划，其中包括儿童医疗服务。这项工作要求在医疗规划方面做出重大改变。儿科急诊医学（PEM）目前在中国尚未被认定为一个专科，并且急诊医疗系统缺乏适当的培训。2006年，加拿大温哥华不列颠哥伦比亚儿童医院国际儿童健康中心和儿科系与中国复旦大学附属儿童医院合作，为在急诊科或重症监护环境中工作的儿科医生启动了一项儿科急诊医学的专科培训项目。主要目标是提升从事儿科急诊医学的急诊医生的专业和临床经验，并通过培训未来的培训人员在中国各地建立儿科急诊医学能力。
在选拔学员后，该项目包括由加拿大和澳大利亚的儿科急诊医学教员在中国进行为期两年的结构化课程培训，然后在加拿大进行儿科急诊医学的实践接触。所有学员在加拿大的最后一轮轮转后都接受了结构化评估。
共有12名学员完成了前两个项目周期。学员们将“培训经历的总体评价”评为“优秀”（12人中有10人）或“良好”（12人中有2人）。所有学员都认为该项目与其实践相关，并认为它将改变他们的实践。他们报告该项目有效，内容的复杂性极佳。
尽管该项目目前取得了成功，但在新专科的发展以及确保其在其他医疗服务提供者和决策者中的接受度方面仍面临挑战。识别和培养一支有能力在中国引领教育活动的培训队伍是艰巨的任务。时间限制、资金和语言障碍是其他挑战。未来的努力应集中在提高和维持复苏能力以及加强分诊系统上。
