Butler Kathryn L, Chang Yuchiao, DeMoya Marc, Feinstein Ara, Ferrada Paula, Maduekwe Ugwuji, Maung Adrian A, Melo Nicolas, Odom Stephen, Olasky Jaisa, Reinhorn Michael, Smink Douglas B, Stassen Nicole, Wilson Chad T, Fagenholz Peter, Kaafarani Haytham, King David, Yeh Daniel D, Velmahos George, Stefanidis Dimitrios
Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge Suite 810, Boston, MA 02114, USA.
Division of Trauma, Emergency Surgery, and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge Suite 810, Boston, MA 02114, USA.
Am J Surg. 2016 Jan;211(1):279-87. doi: 10.1016/j.amjsurg.2015.05.027. Epub 2015 Aug 5.
Patient instability and limited radiology staffing may compel surgeons to make clinical decisions based on their independent interpretations of imaging studies. Despite potential implications for patients, no research to date has assessed the need for a diagnostic radiology curriculum in general surgery residency.
We performed a cross-sectional study of surgery faculty and residents at 13 teaching hospitals across the United States. Survey responses were summarized using frequency and percentage, and analyzed by chi-square, Mantel-Haenszel chi-square, and McNemar tests.
Surveys were distributed to 465 faculty and 520 residents, with response rates of 26% and 30%, respectively. Most respondents reported making decisions based on their independent imaging interpretation at least sometimes, with higher frequency in acute scenarios. The majority voiced a need for a dedicated radiology curriculum, with teaching in chest x-rays, abdominal x-rays, abdominal computed tomography, chest computed tomography, and focused assessment with sonography in trauma examinations.
Surgeons and surgical residents enact treatment plans based on their independent interpretation of imaging studies, especially during acute patient scenarios. Further curricular development efforts are warranted to ensure trainee accuracy in radiologic interpretation.
患者病情不稳定以及放射科人员配备有限，可能迫使外科医生根据他们对影像学研究的独立解读来做出临床决策。尽管这可能对患者产生潜在影响，但迄今为止尚无研究评估普通外科住院医师培训中诊断放射学课程的必要性。
我们对美国13家教学医院的外科教员和住院医师进行了一项横断面研究。调查结果采用频率和百分比进行汇总，并通过卡方检验、Mantel-Haenszel卡方检验和McNemar检验进行分析。
共向465名教员和520名住院医师发放了调查问卷，回复率分别为26%和30%。大多数受访者表示至少有时会根据他们对影像学的独立解读来做出决策，在急性情况下频率更高。大多数人表示需要专门的放射学课程，包括胸部X光、腹部X光、腹部计算机断层扫描、胸部计算机断层扫描以及创伤检查中的超声重点评估等方面的教学。
外科医生和外科住院医师根据他们对影像学研究的独立解读来制定治疗计划，尤其是在急性患者情况下。有必要进一步开展课程开发工作，以确保学员在放射学解读方面的准确性。
