Montuno Anthony, Hunt Bijou R, Lee May M
Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, USA.
Sinai Urban Health Institute, Chicago, IL, USA.
J Community Hosp Intern Med Perspect. 2016 Jul 6;6(3):31054. doi: 10.3402/jchimp.v6.31054. eCollection 2016.
The Society of Hospital Medicine has delineated procedures as one of the core competencies for hospitalists. Little is known about whether exposure to a medical procedure service (MPS) impacts the procedural certification rate in internal medicine trainees in a community hospital training program.
To determine whether or not exposure to an MPS would impact both the number of procedures performed and the rate of resultant certifications in a community hospital internal medicine training program.
Retrospective review.
Five cohorts of resident physicians and their procedure data were analyzed comparing months where residents were unexposed to the intervention (pre-MPS) to months where residents were exposed to the intervention (post-MPS). We calculated the average number of procedures performed per month for pre- versus post-MPS periods. For procedural certification, we compared two proportions: the number of certifications over the number of 6-month pre-MPS periods and the number of certifications over the number of 6-month post-MPS periods.
SETTING/SUBJECTS: The study was conducted at a community-based academic medical center. Subjects included all internal medicine residents.
We found a statistically significant difference between the groups, with pre-MPS groups performing 4.3 procedures per month compared with post-MPS groups performing 6.7 procedures per month (p=0.0010). For certification rates, we found statistically significant differences in several categories - overall, paracentesis, femoral central lines, and jugular central lines.
This study demonstrated that resident exposure to an MPS statistically significantly increased the total number of procedures performed. This study also showed that overall certification rates were statistically significantly different between the pre- and post-MPS groups for several procedures.
医院医学协会已将操作技能列为住院医师的核心能力之一。对于社区医院培训项目中的内科住院医师而言，接触医疗操作服务（MPS）是否会影响其操作技能认证率，目前知之甚少。
确定在社区医院内科培训项目中，接触MPS是否会影响操作技能的执行数量以及由此产生的认证率。
回顾性研究。
分析了五组住院医师及其操作数据，比较住院医师未接触干预措施的月份（MPS前）和接触干预措施的月份（MPS后）。我们计算了MPS前后每月平均执行的操作数量。对于操作技能认证，我们比较了两个比例：MPS前6个月期间的认证数量与MPS后6个月期间的认证数量。
地点/研究对象：该研究在一家社区学术医疗中心进行。研究对象包括所有内科住院医师。
我们发现两组之间存在统计学上的显著差异，MPS前组每月执行4.3次操作，而MPS后组每月执行6.7次操作（p = 0.0010）。对于认证率，我们在几个类别中发现了统计学上的显著差异——总体、腹腔穿刺术、股静脉中心静脉置管术和颈内静脉中心静脉置管术。
本研究表明，住院医师接触MPS在统计学上显著增加了操作的总数。本研究还表明，对于几种操作，MPS前后组之间的总体认证率在统计学上有显著差异。
