Butcher Brad W, Quist Christina E, Harrison James D, Ranji Sumant R
Department of Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
J Hosp Med. 2015 Jan;10(1):8-12. doi: 10.1002/jhm.2270.
The impact of rapid response teams (RRTs) on resident physicians' education and clinical autonomy is not well described.
To determine whether resident physicians perceive educational benefit from collaboration with an RRT and whether they believe that the RRT adversely affects their clinical autonomy.
Survey study.
Study subjects were asked to participate in a brief online survey. The survey contained 7 demographic items and 20 RRT-related items graded on a 5-point Likert scale ranging from strongly disagree to strongly agree.
SETTING/SUBJECTS: The study was conducted at a tertiary care academic medical center. Subjects included all residents in specialties involving direct patient care and the potential to use the adult RRT.
The response rate was 72%; 35% of respondents were interns, and 69% were in medical fields. Residents agreed that working with the RRT is a valuable educational experience (78%) and disagreed that the RRT decreased their clinical autonomy (76%). Surgical residents were less likely than medical residents to perceive educational value from RRT interactions (P = 0.01) or to report collaborative decision making with the RRT (P = 0.04).
The majority of resident physicians perceive educational benefit from interaction with the RRT, though this benefit is greater for less experienced residents and for those residents who routinely provide care for critically ill patients and serve as code team leaders. Few residents, irrespective of years of training or specialty, felt that the RRT reduced their clinical autonomy.
快速反应小组(RRTs)对住院医师教育和临床自主权的影响尚未得到充分描述。
确定住院医师是否认为与RRT合作有教育益处,以及他们是否认为RRT会对其临床自主权产生不利影响。
调查研究。
研究对象被要求参与一项简短的在线调查。该调查包含7个人口统计学项目和20个与RRT相关的项目,这些项目采用从强烈不同意到强烈同意的5点李克特量表进行评分。
设置/对象:该研究在一家三级医疗学术医学中心进行。对象包括所有涉及直接患者护理且有可能使用成人RRT的专科住院医师。
回复率为72%;35%的受访者为实习生,69%从事医学领域。住院医师一致认为与RRT合作是一次有价值的教育经历(78%),并不同意RRT降低了他们的临床自主权(76%)。外科住院医师比内科住院医师更不太可能从与RRT的互动中感知到教育价值(P = 0.01),或报告与RRT的协作决策(P = 0.04)。
大多数住院医师认为与RRT互动有教育益处,尽管对于经验较少的住院医师以及那些常规为重症患者提供护理并担任抢救团队负责人的住院医师来说,这种益处更大。很少有住院医师,无论培训年限或专业如何,认为RRT降低了他们的临床自主权。