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放射学报告周转时间:对住院医师教育的影响。

Radiology report turnaround time: effect on resident education.

作者信息

England Eric, Collins Jannette, White Richard D, Seagull F Jacob, Deledda John

机构信息

Department of Radiology, University of Cincinnati Medical Center, 234 Goodman Street, ML 0761, Cincinnati, OH 45267-0761.

University of Cincinnati College of Medicine, Cincinnati, Ohio.

出版信息

Acad Radiol. 2015 May;22(5):662-7. doi: 10.1016/j.acra.2014.12.023.

Abstract

RATIONALE AND OBJECTIVES

To compare resident workload from Emergency Department (ED) studies before and after the implementation of a required 1-hour report turnaround time (TAT) and to assess resident and faculty perception of TAT on resident education.

MATERIALS AND METHODS

Resident study volume will be compared for 3 years before and 1 year after the implementation of a required 1-hour TAT. Changes to resident workload will be compared among the different radiology divisions (body, muscuolskeletal (MSK), chest, and neuro), as well as during different shifts (daytime and overnight). Residents and faculty at two Midwest institutions, both of which have a required report TAT, will be invited to participate in an online survey to query the perceived effect on resident education by implementation of this requirement. A P < .05 was considered statistically significant.

RESULTS

A significant decrease in resident involvement in ED studies was noted in the MSK, chest, and neuro sections with average involvement of the 3 years before the 1-hour TAT of 89%, 88%, and 82%, respectively, which decreased to 66%, 68%, and 51% after the 1-hour TAT requirement (P < .05). The resident involvement in ED studies only mildly decreased in the body section from an average before the 1-hour TAT of 87% to 80% after the 1-hour TAT requirement (P < .1). There was an overall significant decrease in resident ED study involvement during the daytime (P = .01) but not after hours during resident call (P = .1). Seventy percent of residents (43 of 61) and 55% of faculty (63 of 114) responded to our surveys. Overall, residents felt their education from ED studies during the daytime and overnight were good. However, residents who were present both before and after the implementation of a required TAT felt their education had been significantly negatively affected. Faculty surveyed thought that the required TAT negatively affected their ability to teach and decreased the quality of resident education.

CONCLUSIONS

Residents are exposed to fewer ED studies after the implementation of a required 1-hour TAT. Overall, the current residents do not feel this decreased exposure to Emergency room studies affects their education. However, residents in training before and after this requirement feel their education has been significantly affected. Faculty perceives that the required TAT negatively affects their ability to teach, as well as the quality of resident education.

摘要

原理与目的

比较实施要求的1小时报告周转时间(TAT)前后急诊科(ED)研究中住院医师的工作量,并评估住院医师和教员对TAT对住院医师教育影响的看法。

材料与方法

将在实施要求的1小时TAT之前的3年和之后的1年比较住院医师的研究量。将在不同的放射科(身体、肌肉骨骼(MSK)、胸部和神经科)以及不同班次(白天和夜间)之间比较住院医师工作量的变化。来自两个中西部机构的住院医师和教员(这两个机构都有要求的报告TAT)将被邀请参加一项在线调查,以询问实施该要求对住院医师教育的感知影响。P <.05被认为具有统计学意义。

结果

在MSK、胸部和神经科,住院医师参与ED研究的比例显著下降,1小时TAT之前3年的平均参与率分别为89%、88%和82%,在1小时TAT要求实施后降至66%、68%和51%(P <.05)。在身体科,住院医师参与ED研究的比例仅略有下降,从1小时TAT之前的平均87%降至1小时TAT要求实施后的80%(P <.1)。白天住院医师参与ED研究的比例总体上显著下降(P =.01),但在住院医师值班的非工作时间没有下降(P =.1)。61名住院医师中有70%(43名)和114名教员中有55%(63名)回复了我们的调查。总体而言,住院医师认为他们在白天和夜间从ED研究中获得的教育是良好的。然而,在实施要求的TAT之前和之后都参与的住院医师认为他们的教育受到了显著的负面影响。接受调查的教员认为要求的TAT对他们的教学能力产生了负面影响,并降低了住院医师教育的质量。

结论

实施要求的1小时TAT后,住院医师接触的ED研究减少。总体而言,目前的住院医师不认为这种接触急诊室研究的减少会影响他们的教育。然而,在这一要求实施之前和之后接受培训的住院医师认为他们的教育受到了显著影响。教员认为要求的TAT对他们的教学能力以及住院医师教育的质量产生了负面影响。

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