Swords C, Smith M E, Wasson J D, Qayyum A, Tysome J R
Department of Otolaryngology, Head and Neck Surgery,Addenbrooke's Hospital,Cambridge.
Department of Otolaryngology, Head and Neck Surgery,Peterborough City Hospital,UK.
J Laryngol Otol. 2017 Feb;131(2):106-112. doi: 10.1017/S002221511601001X. Epub 2017 Jan 10.
First-on-call ENT cover is often provided by junior doctors with limited ENT experience; yet, they may have to manage life-threatening emergencies. An intensive 1-day simulation course was developed to teach required skills to junior doctors.
A prospective, single-blinded design was used. Thirty-seven participants rated their confidence before the course, immediately following the course and after a two-month interval. Blinded assessors scored participant performance in two video-recorded simulated scenarios before and after the course.
Participant self-rated confidence was increased in the end-of-course survey (score of 27.5 vs 53.0; p < 0.0001), and this was maintained two to four months after the course (score of 50.5; p < 0.0001). Patient assessment and management in video-recorded emergency scenarios was significantly improved following course completion (score of 9.75 vs 18.75; p = 0.0093).
This course represents an effective method of teaching ENT emergency management to junior doctors. ENT induction programmes benefit from the incorporation of a simulation component.
首次值班的耳鼻喉科（ENT）值班工作通常由耳鼻喉科经验有限的初级医生承担；然而，他们可能不得不处理危及生命的紧急情况。为此开发了一个为期1天的强化模拟课程，向初级医生传授所需技能。
采用前瞻性单盲设计。37名参与者在课程开始前、课程结束后立即以及间隔两个月后对自己的信心进行了评分。盲法评估人员在课程前后对参与者在两个视频记录的模拟场景中的表现进行评分。
在课程结束时的调查中，参与者的自我评估信心有所提高（分数从27.5提高到53.0；p<0.0001），并且在课程结束两到四个月后仍保持这一水平（分数为50.5；p<0.0001）。课程结束后，视频记录的紧急场景中的患者评估和管理有显著改善（分数从9.75提高到18.75；p=0.0093）。
本课程是向初级医生传授耳鼻喉科急诊管理的有效方法。耳鼻喉科入职培训计划受益于纳入模拟部分。
