Centre for Medical Education, University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh, UK.
Postgrad Med J. 2012 Jul;88(1041):365-71. doi: 10.1136/postgradmedj-2011-130232. Epub 2011 Dec 13.
The ability to recognise acutely unwell patients and to instigate generic resuscitation is essential for all newly qualified doctors. The aim of this review is to synthesise recent work examining the perceived preparedness of UK medical graduates in acute care, relative to the other outcomes detailed in Tomorrow's Doctors (2009).
A systematic literature search was performed using five databases. It sought literature related to preparedness in acute care and other Tomorrow's Doctors outcomes from the perspectives of the graduates themselves and their professional colleagues. Two researchers undertook data extraction and quality scoring, and preparedness ratings in each outcome were mapped to a generic rating scale to allow comparison between studies.
256 articles were recovered, with 10 included in the final analysis. The 10 articles suggested that graduates perceive themselves to be least well prepared in acute care and prescribing. Their professional colleagues perceive them to be less prepared in acute care than in any of the other outcomes and perceive preparedness in acute care to have declined since the first publication of Tomorrow's Doctors. Furthermore, there is evidence that preparedness in acute care is an area of concern for UK graduates.
The assimilation of evidence in this review suggests that recent changes in UK undergraduate training, while improving preparedness in some areas, may have neglected acute care. While not a good surrogate for actual preparedness, perceived preparedness is important in influencing the behaviour of new graduates and therefore warrants further consideration.
识别病情急剧恶化的患者并启动常规复苏的能力对所有新入职的医生而言至关重要。本研究旨在综合近期有关英国医学毕业生在急症护理方面的准备情况的研究，这些研究结果与《明日医生》（2009 年）中详述的其他结果相关。
采用 5 个数据库进行系统文献检索。它旨在从毕业生自身及其专业同事的角度，寻找与急症护理准备情况和其他《明日医生》结果相关的文献。两名研究人员负责数据提取和质量评分，并将每个结果的准备情况评分映射到通用评分量表，以比较研究之间的差异。
共检索到 256 篇文章，其中 10 篇纳入最终分析。这 10 篇文章表明，毕业生认为自己在急症护理和处方方面的准备最差。其专业同事认为他们在急症护理方面的准备不如其他任何结果，并且认为自《明日医生》首次出版以来，急症护理方面的准备情况有所下降。此外，有证据表明，急症护理准备情况是英国毕业生关注的一个领域。
本综述中证据的综合表明，英国本科培训的近期改革虽然在某些方面提高了准备情况，但可能忽视了急症护理。虽然不能作为实际准备情况的良好替代指标，但感知准备情况对于影响新毕业生的行为非常重要，因此值得进一步考虑。
