Woelfel Ingrid A, Takabe Kazuaki
Division of Surgical Oncology, Department of Surgery, Virginia Commonwealth University School of Medicine and Massey Cancer Center, Breast Surgery, Roswell Park Cancer Institute, Richmond, Virginia.
Division of Surgical Oncology, Department of Surgery, Virginia Commonwealth University School of Medicine and Massey Cancer Center, Breast Surgery, Roswell Park Cancer Institute, Richmond, Virginia.
J Surg Res. 2016 Aug;204(2):351-360. doi: 10.1016/j.jss.2016.05.004. Epub 2016 May 10.
Intravenous (IV) catheter placement is one of the most basic and essential medical procedures. However, IV placement can be a source of anxiety for medical students as it is often their first procedural patient care. We sought to investigate the factors that impact the success rate of this skill and to determine at what rate students improve.
A confidential web-based survey was distributed to a total of 367 third and fourth year students at Virginia Commonwealth University School of Medicine. The responses were collected over a 2-wk period in July 2015.
The response rate was 49.0% (180/367); 65.5% of the M3s and 21.8% of the M4s have never had an opportunity to place an IV. The success rate was higher in students with prior experience as laboratory researchers (86.6%, P = 0.014) as well as emergency medical technicians (81.4%, P = 0.038) when compared to students with no experience. Prior preparation such as reading, watching videos, or even lectures did not increase the success rate. Success rates rapidly improved from 47% for the first attempt to 86% for the fifth attempt.
A significant percentage of students did not have opportunities to attempt IV catheter placement. We found prior experience, not only as an emergency medical technician but also as a laboratory researcher, significantly increased the success rate. Prior preparations did not improve success rate, and most of the students were successful after only five attempts.
静脉(IV)导管置入是最基本且重要的医疗操作之一。然而,静脉置管可能会让医学生感到焦虑,因为这通常是他们首次进行的患者护理操作。我们试图调查影响这项技能成功率的因素,并确定学生的提高速度。
向弗吉尼亚联邦大学医学院的367名三年级和四年级学生发放了一份基于网络的保密调查问卷。2015年7月,在两周时间内收集了回复。
回复率为49.0%(180/367);65.5%的三年级学生和21.8%的四年级学生从未有机会进行静脉置管。与没有经验的学生相比,有实验室研究经验的学生成功率更高(86.6%,P = 0.014),有紧急医疗技术员经验的学生成功率也更高(81.4%,P = 0.038)。阅读、观看视频甚至讲座等预先准备并未提高成功率。成功率从首次尝试的47%迅速提高到第五次尝试的86%。
相当比例的学生没有机会尝试静脉导管置入。我们发现,不仅作为紧急医疗技术员,而且作为实验室研究人员的先前经验,显著提高了成功率。预先准备并未提高成功率,而且大多数学生仅经过五次尝试就成功了。