Department of Orthopaedic Surgery, Hand and Microsurgery Section, Tan Tock Seng Hospital, Singapore.
Singapore Med J. 2012 Aug;53(8):522-5.
Hand surgery is a subspecialty with a dedicated training programme in Singapore. Currently, Singapore is one of two countries in the world that still provides dedicated advanced hand specialty training. As hand surgeons depend on referrals from institutions and general practitioners, appropriate hand surgical referral requires the referring physician to have knowledge and understanding of common hand conditions as well as less common but more urgent surgical conditions, and their available surgical treatments. This study aimed to determine the knowledge of hand surgery and hand surgical conditions among general practitioners.
A questionnaire survey was conducted during a continuing medical education symposium on hand surgery in Singapore. Participants responded to 12 questions on hand trauma by keying the answers into a computer database system. The results were then analysed.
A total of 35 general practitioners responded to our survey, and they were able to answer 53% of the questions correctly. We found knowledge gaps among the participants regarding hand surgical conditions, and identified areas where increased education during medical school, postgraduate training and continuing medical education may be beneficial. Areas that were found to be weak included recognising injuries that pose a high risk for developing wound infection, complications of topical steroid injection in trigger finger treatment and hand tumours.
Improving hand surgery knowledge among general practitioners not only leads to improved primary care, but it can also facilitate prompt recognition of surgical problems and subsequent referral to appropriate hand surgeons for treatment. This may possibly reduce the load of tertiary institutions in treating non-urgent hand conditions.
手外科学是一个专科，在新加坡有专门的培训计划。目前，新加坡是世界上仅有的两个仍提供专门的高级手外科培训的国家之一。由于手外科医生依赖于机构和全科医生的转诊，因此，适当的手外科转诊要求转诊医生对手部常见疾病以及不太常见但更紧急的手术情况及其可用的手术治疗方法有一定的了解和认识。本研究旨在确定全科医生对手外科学和手部手术条件的了解程度。
在新加坡手外科学继续教育研讨会上进行了问卷调查。参与者通过将答案输入计算机数据库系统来回答 12 个手部创伤问题。然后对结果进行分析。
共有 35 名全科医生对我们的调查做出了回应，他们能够正确回答 53%的问题。我们发现参与者在手外科疾病方面存在知识差距，并确定了在医学院、研究生培训和继续医学教育期间增加教育可能有益的领域。发现薄弱的领域包括识别可能导致伤口感染的高风险损伤、扳机指治疗中局部皮质类固醇注射的并发症以及手部肿瘤。
提高全科医生对手外科学的了解不仅可以改善初级保健，还可以促进对手部手术问题的快速识别，并随后将其转介给合适的手外科医生进行治疗。这可能会减少三级医疗机构治疗非紧急手部疾病的负担。
