Ripoll Gallardo Alba, Ingrassia Pier Luigi, Ragazzoni Luca, Djalali Ahmadreza, Carenzo Luca, Burkle Frederick M, Della Corte Francesco
1Research Center in Emergency and Disaster Medicine and Computer Science Applied to Medical Practice (CRIMEDIM),Università del Piemonte Orientale,Novara,Italy.
2Harvard Humanitarian Initiative,Harvard School of Public Health,Cambridge,MassachusettsUSA.
Prehosp Disaster Med. 2015 Feb;30(1):16-21. doi: 10.1017/S1049023X14001320. Epub 2014 Dec 15.
Over the last decades, humanitarian crises have seen a sharp upward trend. Regrettably, physicians involved in humanitarian action have often demonstrated incomplete preparation for these compelling events which have proved to be quite different from their daily work. Responders to these crises have included an unpredictable mix of beginner-level, mid-level, and expert-level providers. The quality of care has varied considerably. The international humanitarian community, in responding to international calls for improved accountability, transparency, coordination, and a registry of professionalized international responders, has recently launched a call for further professionalization within the humanitarian assistance sector, especially among academic-affiliated education and training programs. As anesthetists have been involved traditionally in medical relief operations, and recent disasters have seen a massive engagement of young physicians, the authors conducted, as a first step, a poll among residents in Anesthesia and Critical Care Medicine in Italy to evaluate their interest in participating in competency-based humanitarian assistance education and in training incorporated early in residencies.
The Directors of all the 39 accredited anesthesia/critical care training programs in Italy were contacted and asked to submit a questionnaire to their residents regarding the objectives of the poll study. After acceptance to participate, residents were enrolled and asked to complete a web-based poll.
A total of 29 (74%) of the initial training programs participated in the poll. Out of the 1,362 questionnaires mailed to residents, 924 (68%) were fully completed and returned. Only 63(6.8%) of the respondents voiced prior participation in humanitarian missions, but up to 690 (74.7%) stated they were interested in participating in future humanitarian deployments during their residency that carried over into their professional careers. Countrywide, 896 (97%) favored prior preparation for residents before participating in humanitarian missions, while the need for a specific, formal, professionalization process of the entire humanitarian aid sector was supported by 889 (96.2%).
In Italy, the majority of anesthesia/critical care residents, through a formal poll study, affirmed interest in participating in humanitarian assistance missions and believe that further professionalization within the humanitarian aid sector is required. These results have implications for residency training programs worldwide.
在过去几十年里,人道主义危机呈急剧上升趋势。遗憾的是,参与人道主义行动的医生往往对这些紧迫事件准备不足,事实证明这些事件与他们的日常工作大不相同。应对这些危机的人员包括初、中、高级水平参差不齐的各类医疗人员。医疗服务质量差异很大。国际人道主义界为回应国际社会对提高问责制、透明度、协调性以及建立专业化国际救援人员登记册的呼吁,最近呼吁在人道主义援助部门进一步实现专业化,尤其是在与学术机构相关的教育和培训项目中。由于麻醉师传统上一直参与医疗救援行动,且近期灾难中有大量年轻医生参与其中,作者首先在意大利麻醉与重症医学住院医师中进行了一项调查,以评估他们参与基于能力的人道主义援助教育以及在住院医师培训早期就纳入相关培训的兴趣。
联系了意大利所有39个经认可的麻醉/重症监护培训项目的主任,并要求他们向其住院医师发放一份关于此次调查研究目标的问卷。在获得参与许可后,住院医师被纳入研究并要求完成一项在线调查。
共有29个(74%)初始培训项目参与了此次调查。在寄给住院医师的1362份问卷中,924份(68%)被完整填写并返回。只有63名(6.8%)受访者表示曾参与过人道主义任务,但多达690名(74.7%)表示他们有兴趣在住院医师培训期间及之后的职业生涯中参与未来的人道主义部署。在全国范围内,896名(97%)受访者赞成在住院医师参与人道主义任务前进行预先培训,而889名(96.2%)受访者支持对整个人道主义援助部门进行特定、正式的专业化培训。
在意大利,大多数麻醉/重症监护住院医师通过一项正式的调查研究,表明有兴趣参与人道主义援助任务,并认为人道主义援助部门需要进一步专业化。这些结果对全球范围内的住院医师培训项目具有启示意义。