Snider Tristan, Melady Don, Costa Andrew P
*The Royal College Emergency Medicine Residency Program,Division of Emergency Medicine,Department of Medicine,University of Toronto,Toronto,ON.
†Schwartz/Reisman Emergency Centre,Mount Sinai Hospital,Toronto,ON.
CJEM. 2017 Jan;19(1):9-17. doi: 10.1017/cem.2016.27. Epub 2016 Apr 18.
Geriatric patients represent a large and complex subgroup seen in emergency departments (EDs). Competencies in geriatric emergency medicine (EM) training have been established. Our objectives were to examine Canadian postgraduate year (PGY)-5 EM residents' comfort with the geriatric EM competency domains, assess whether Canadian EM residents become more comfortable through residency, and determine whether geriatric educational exposures are correlated with resident comfort with geriatric EM.
A national, cross-sectional study of PGY-1 and PGY-5 Royal College EM residents was conducted to determine their comfort in geriatric EM clinical competency domains. Residents reported their level of comfort in satisfying each competency domain using a seven-point Likert scale. Residents were also asked about the location of their medical education as well as the type and number of different geriatric exposures that they had received to date.
Of the 141 eligible residents from across Canada, 77% (109) consented to participate. None of the PGY-1 EM residents and 34% (14) of PGY-5 EM residents reported that they were comfortable with all eight geriatric EM competency domains. PGY-5 EM residents were significantly more comfortable than PGY-1 EM residents. Residents reported a highly variable range of geriatric educational exposures obtained during training. No relationship was found between resident-reported comfort and the nature or number of geriatric exposures that they had received.
Current Royal College EM residency training in Canada may not be adequately preparing graduates to be comfortable with defined competencies for the care of older ED patients.
老年患者是急诊科中数量众多且情况复杂的亚群体。老年急诊医学(EM)培训的能力标准已经确立。我们的目标是检查加拿大研究生医学教育第5年(PGY-5)的急诊医学住院医师对老年急诊医学能力领域的熟悉程度,评估加拿大急诊医学住院医师在住院期间是否变得更加熟悉,以及确定老年医学教育经历是否与住院医师对老年急诊医学的熟悉程度相关。
对PGY-1和PGY-5的皇家内科医学院急诊医学住院医师进行了一项全国性横断面研究,以确定他们在老年急诊医学临床能力领域的熟悉程度。住院医师使用七点李克特量表报告他们在满足每个能力领域方面的熟悉程度。住院医师还被问及他们医学教育的地点以及他们迄今为止接受的不同老年医学接触的类型和数量。
在来自加拿大各地的141名符合条件的住院医师中,77%(109名)同意参与。没有PGY-1急诊医学住院医师,34%(14名)的PGY-5急诊医学住院医师报告称他们对所有八个老年急诊医学能力领域都感到熟悉。PGY-5急诊医学住院医师比PGY-1急诊医学住院医师明显更熟悉。住院医师报告称在培训期间获得的老年医学教育经历范围差异很大。在住院医师报告的熟悉程度与他们接受的老年医学接触的性质或数量之间未发现关联。
加拿大目前皇家内科医学院的急诊医学住院医师培训可能没有充分使毕业生熟悉照顾老年急诊科患者的既定能力。