The Pulmonary Center, Boston University School of Medicine, 72 E. Concord Street, R-304, Boston, MA 02118.
J Crit Care. 2013 Oct;28(5):857-61. doi: 10.1016/j.jcrc.2013.06.003. Epub 2013 Jul 20.
Given decreasing use of pulmonary artery (PA) catheterization, we sought to evaluate whether current pulmonary and critical care fellows have adequate opportunity to obtain proficiency in PA catheter placement and data interpretation.
All US pulmonary and critical care program directors were invited to participate in an anonymous online survey regarding current training opportunities in PA catheterization.
The response rate was 51% (69/136). Eighty-three percent reported that the number of PA catheterizations performed by fellows within their program has decreased in the past decade. Fifty-four percent estimated that their fellows currently participate in less than 10 supervised procedures during fellowship. The most frequently identified barriers to training were procedure volume and reluctance to place PA catheters in the medical intensive care unit. Forty-three percent of respondents agreed that training in PA catheter placement is currently adequate within their program, and 55% agreed that training in data interpretation is adequate. Only 39% of respondents believe that PA catheter placement should continue to be an Accreditation Council for Graduate Medical Education training requirement.
Many current pulmonary and critical care fellows do not have the opportunity to gain proficiency in PA catheterization. Fellowship training programs should consider alternate means of training fellows in PA catheter data interpretation, such as simulation.
鉴于肺动脉(PA)导管插入术的使用减少,我们评估目前的肺科和重症监护住院医师是否有足够的机会获得 PA 导管放置和数据解读的熟练程度。
邀请所有美国肺科和重症监护项目主任参加一项关于 PA 导管插入术当前培训机会的匿名在线调查。
回复率为 51%(69/136)。83%的人报告说,在过去十年中,他们所在项目的住院医师进行的 PA 导管插入术数量减少了。54%的人估计他们的住院医师目前在住院医师期间参与的监督程序少于 10 次。培训的最常见障碍是程序量和不愿在重症监护病房放置 PA 导管。43%的受访者认为他们所在项目的 PA 导管放置培训目前足够,55%的人认为数据解读培训足够。只有 39%的受访者认为 PA 导管放置应继续作为研究生医学教育认证委员会的培训要求。
许多目前的肺科和重症监护住院医师没有机会获得 PA 导管插入术的熟练程度。住院医师培训计划应考虑替代方法来培训住院医师进行 PA 导管数据解读,例如模拟。