Department of Hospital Medicine, Children's National Health Systems, Washington, DC.
George Washington School of Medicine and Health Science, Washington, DC.
J Hosp Med. 2015 Jun;10(6):373-9. doi: 10.1002/jhm.2337. Epub 2015 Mar 6.
The pediatric hospital medicine (PHM) core competencies were established in 2010 to identify the specific knowledge base and skill set needed to provide the highest quality of care for hospitalized children. The objectives of this study were to examine the perceived core competency achievements of fellowship-trained and non-fellowship-trained early career pediatric hospitalists and identify perceived gaps in our current training models.
An anonymous Web-based survey was distributed in November 2013. Hospitalists within 5 years of their residency graduation reported their perceived competency in select PHM core competencies. χ(2) and multiprobit regression analyses were utilized.
One hundred ninety-seven hospitalists completed the survey and were included; 147 were non-fellowship-trained and 50 were PHM fellowship graduates or current PHM fellows. Both groups reported feeling less than competent in sedation and aspects of business practice. Non-fellowship-trained hospitalists also reported mean scores in the less than competent range in intravenous access/phlebotomy, technology-dependent emergencies, performing Plan-Do-Study-Act process and root cause analysis, defining basic statistical terms, and identifying research resources. Non-fellowship-trained hospitalists reported mean competency scores greater than fellowship-trained hospitalists in pain management, newborn care, and transitions in care.
Early career pediatric hospitalists report deficits in several of the PHM core competencies, which should be considered when designing PHM-specific training in the future. Fellowship-trained hospitalists report higher levels of perceived competency in many core areas.
儿科医院医学(PHM)核心能力于 2010 年确立,旨在确定为住院儿童提供最高质量护理所需的特定知识库和技能组合。本研究的目的是检查接受过 fellowship 培训和未接受过 fellowship 培训的儿科医院医生早期职业生涯中对核心能力的感知成就,并确定我们当前培训模式中的感知差距。
2013 年 11 月进行了一项匿名网络调查。在住院医师毕业后 5 年内的医院医生报告了他们在选定的 PHM 核心能力方面的感知能力。采用 χ(2)和多比例回归分析。
197 名医院医生完成了调查并被纳入研究;147 名未接受过 fellowship 培训,50 名是 PHM 奖学金毕业生或现任 PHM 研究员。两组均报告在镇静和部分商业实践方面感觉能力不足。未接受过 fellowship 培训的医院医生在静脉通路/采血、技术依赖的紧急情况、执行计划-执行-研究-行动过程和根本原因分析、定义基本统计术语以及识别研究资源方面的平均得分也在能力不足范围内。未接受过 fellowship 培训的医院医生在疼痛管理、新生儿护理和护理过渡方面的平均能力得分高于接受过 fellowship 培训的医院医生。
早期职业生涯的儿科医院医生报告在几个 PHM 核心能力方面存在不足,在未来设计 PHM 特定培训时应考虑这些不足。接受过 fellowship 培训的医院医生在许多核心领域报告的感知能力更高。