Emergency Medicine Residency, Washington Hospital Cente, Washington, DC, USA.
Acad Emerg Med. 2012 Feb;19(2):174-9. doi: 10.1111/j.1553-2712.2011.01274.x. Epub 2012 Jan 30.
Emergency medical services (EMS) was recently approved as a subspecialty by the American Board of Medical Specialties, highlighting the core content of knowledge that encompasses prehospital emergency patient care. This study aimed to describe the current state of EMS education at emergency medicine (EM) residency programs in the United States.
The authors distributed an online survey containing multiple-choice and free-response questions pertaining to resident EMS education to the directors of EM residency programs in the United States between July 21 and September 10, 2010.
Of 154 programs, 117 (75%) responded to the survey, and 108 (70%) completed the survey by answering all required questions. Of completed surveys, 82 programs (76%) reported the cumulative time devoted to EMS didactic education during the course of residency training, a median of 20 hours (range = 3 to 300 hours; interquartile range [IQR] = 12 to 36 hours). There is a designated EMS rotation in 89% of programs, with a median duration of 3 weeks (range = 1 to 9 weeks; IQR = 2 to 4 weeks). Most programs involve residents on EMS rotations strictly as in-field observers (63%), some as in-field providers (20%), and the rest with some combination of the two roles. Ground ride-along is required in 94% of programs, while air ride-along is mandatory in 4% and optional in 81% of programs. Direct medical oversight (DMO) certification is required in 41% of residency programs, but not available in 26% of program jurisdictions. Residents in 92% of programs provide DMO. In those programs, most residents (77%) provide DMO primarily while working in the emergency department (ED), 13% during dedicated EMS or medical oversight shifts, and 4% during a combination of these shifts. Disaster-preparedness was most frequently listed as the component programs would like to add to their EMS curricula.
There is a wide range in the didactic, online, and in-field EMS educational experiences provided as part of EM training. Most residents participate in ground ride-along activities, provide DMO, and have a dedicated EMS rotation. Disaster-preparedness is the most common desired addition to existing EMS rotations.
急救医疗服务（EMS）最近被美国医学专业委员会批准为一个亚专科，突出了涵盖院前急诊患者护理的核心知识内容。本研究旨在描述美国急诊医学（EM）住院医师培训项目中 EMS 教育的现状。
作者于 2010 年 7 月 21 日至 9 月 10 日向美国 EM 住院医师培训项目主任分发了一份在线调查，其中包含有关住院医师 EMS 教育的多项选择题和自由回答问题。
在 154 个项目中，有 117 个（75%）对调查做出了回应，有 108 个（70%）通过回答所有必需的问题完成了调查。在完成的调查中，82 个项目（76%）报告了住院医师培训期间 EMS 理论教育所花费的累计时间，中位数为 20 小时（范围=3 至 300 小时；四分位距[IQR]=12 至 36 小时）。有 89%的项目有指定的 EMS 轮转，轮转时间中位数为 3 周（范围=1 至 9 周；IQR=2 至 4 周）。大多数项目让住院医师严格作为现场观察者参与 EMS 轮转（63%），一些项目让住院医师作为现场提供者参与（20%），其余项目则让住院医师扮演这两种角色的某种组合。94%的项目要求进行地面随车出诊，4%的项目要求进行空中随车出诊，81%的项目则允许选择是否进行空中随车出诊。41%的住院医师培训项目要求获得直接医疗监督（DMO）认证，但 26%的项目管辖范围内无法获得该认证。92%的项目中的住院医师提供 DMO。在这些项目中，大多数住院医师（77%）主要在急诊部（ED）工作时提供 DMO，13%在专门的 EMS 或医疗监督轮班时提供 DMO，4%在这些轮班的组合中提供 DMO。灾难准备是项目最常希望添加到其 EMS 课程中的内容。
作为 EM 培训的一部分，提供的 EMS 理论、在线和现场教育经验存在广泛差异。大多数住院医师参与地面随车出诊活动、提供 DMO 并进行专门的 EMS 轮转。灾难准备是对现有 EMS 轮转最常见的期望补充。
