Levy Rebecca, Dubrowski Adam, Amin Harish, Bismilla Zia
Division of Pediatric Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario;
Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta.
Paediatr Child Health. 2014 Apr;19(4):180-4. doi: 10.1093/pch/19.4.180.
The Royal College of Physicians and Surgeons of Canada (RCPSC) sets objectives for residency training, including many skills that may not be commonly performed in practice.
To describe attitudes of residents enrolled in Canadian paediatric residency programs toward procedural skills training, including perception of importance and perceived proficiency of the RCPSC-required procedures.
An anonymous electronic survey was distributed to all senior residents enrolled in Canadian paediatric residencies, using a five-point Likert scale to address procedural importance and corresponding proficiency. Data were analyzed using descriptive statistics, with Pearson correlation coefficients used to describe relationships among variables.
A total of 68 residents responded. Fifteen skills had a mean importance ≥4 (very or extremely important) and five skills had a mean rating <3 (somewhat or not important). Residents believed they were extremely or very proficient (mean rating ≥4) for three skills (bag-mask ventilation, lumbar puncture and chest x-ray interpretation). They reported 23 procedures for which they felt somewhat to not proficient (mean <3). The correlation between importance and proficiency was high (Pearson's correlation coefficient = 0.87). However, proficiency was significantly lower than importance (P<0.05) for the majority of procedures (88%). The largest gaps between importance and proficiency were observed for chest tube insertion, gathering evidence of child maltreatment, defibrillation and intraosseous insertion.
Many, but not all, RCPSC-required procedures are believed to be important. Residents do not believe that they are adequately proficient in many of these procedures. Skills with the greatest gap between importance and proficiency may be targets for curricular interventions.
加拿大皇家内科医师与外科医师学院（RCPSC）设定了住院医师培训目标，其中包括许多在实际操作中可能不常执行的技能。
描述参加加拿大儿科住院医师培训项目的住院医师对操作技能培训的态度，包括对RCPSC要求的操作的重要性认知和自我评估的熟练程度。
对所有参加加拿大儿科住院医师培训的高年级住院医师进行匿名电子调查，使用五点李克特量表来评估操作的重要性和相应的熟练程度。采用描述性统计分析数据，用Pearson相关系数描述变量之间的关系。
共有68名住院医师回复。15项技能的平均重要性≥4（非常或极其重要），5项技能的平均评分<3（有些或不重要）。住院医师认为他们在三项技能（面罩通气、腰椎穿刺和胸部X光解读）方面极其或非常熟练（平均评分≥4）。他们报告了23项他们感觉有些不熟练至非常不熟练（平均<3）的操作。重要性和熟练程度之间的相关性很高（Pearson相关系数=0.87）。然而，大多数操作（88%）的熟练程度显著低于重要性（P<0.05）。在胸腔置管、收集虐待儿童证据、除颤和骨髓腔内穿刺方面，重要性和熟练程度之间的差距最大。
许多但并非所有RCPSC要求的操作都被认为是重要的。住院医师认为他们在许多这些操作中并不足够熟练。重要性和熟练程度之间差距最大的技能可能是课程干预的目标。
