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利用模拟实验室培训放射科住院医师处理急性放射急症。

Use of a simulation laboratory to train radiology residents in the management of acute radiologic emergencies.

机构信息

Department of Radiology, Penn State Hershey Medical Center, 500 University Dr, H066, Hershey, PA 17033, USA.

出版信息

AJR Am J Roentgenol. 2012 Aug;199(2):244-51. doi: 10.2214/AJR.11.7892.

Abstract

OBJECTIVE

Simulation laboratories use realistic clinical scenarios to train physicians in a controlled environment, especially in potentially life-threatening complications that require prompt management. The objective of our study was to develop a comprehensive program using the simulation laboratory to train radiology residents in the management of acute radiologic emergencies.

MATERIALS AND METHODS

All radiology residents attended a dedicated simulation laboratory course lasting 3 hours, divided over two sessions. Training included basic patient management skills, management of a tension pneumothorax, massive hemorrhage, and contrast agent reactions. Participants were presented with 20 multiple-choice questions before and after the course. Pre- and posttest results were analyzed, and the McNemar test was used to compare correct responses by individual question.

RESULTS

Twenty-six radiology residents attended the class. The average pre- and posttest scores and the average difference between the scores for all residents were 13.8, 17.1, and 3.3, respectively (p < 0.0001). Incorrect answers on the pretest examination that were subsequently answered correctly concerned administration of epinephrine for severe reactions, management of a tension pneumothorax, oxygen therapy, ECG placement, cardiopulmonary resuscitation technique, and where to stand during a code situation. Persistent incorrect answers concerned vasovagal reactions and emergency telephone numbers at an off-site imaging center.

CONCLUSION

Simulation laboratories can be used to teach crisis management and crisis resource management for radiology residents and should be part of the education toolbox. Defined objectives lead to a comprehensive course dealing with the management of acute radiologic emergencies. Such programs can improve the role of radiologists as members of the health care team.

摘要

目的

模拟实验室使用逼真的临床场景在受控环境中培训医生,尤其是在需要及时处理的潜在危及生命的并发症方面。我们研究的目的是开发一个综合计划,利用模拟实验室培训放射科住院医师处理急性放射急症。

材料和方法

所有放射科住院医师参加了为期 3 小时的专门模拟实验室课程,分为两个阶段。培训包括基本的患者管理技能、张力性气胸、大量出血和造影剂反应的管理。课程前后向参与者提出了 20 个多项选择题。分析了预测试和后测试结果,并使用 McNemar 检验比较了个别问题的正确答案。

结果

26 名放射科住院医师参加了该课程。所有住院医师的平均预测试和后测试分数以及分数之间的平均差异分别为 13.8、17.1 和 3.3(p <0.0001)。预测试中答错但随后答对的问题涉及严重反应时肾上腺素的给药、张力性气胸的处理、氧气治疗、心电图放置、心肺复苏技术以及代码情况下应站在哪里。持续答错的问题涉及血管迷走反应和场外成像中心的紧急电话号码。

结论

模拟实验室可用于教授放射科住院医师的危机管理和危机资源管理,应成为教育工具箱的一部分。明确的目标可制定出全面的课程,以处理急性放射急症的管理。此类计划可以提高放射科医生作为医疗保健团队成员的作用。

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