Mickells Geoffrey E, Goodman Denise M, Rozenfeld Ranna A
Division of Critical Care Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Children's Healthcare of Atlanta at Scottish Rite, Section of Pediatric Critical Care Medicine, Neonatology Associates of Atlanta, Atlanta, GA, USA.
BMC Pediatr. 2017 Jan 13;17(1):13. doi: 10.1186/s12887-017-0780-5.
The transport of critically ill patients to children's hospitals is essential to current practice. The AAP Section on Transport Medicine has raised concerns about future leadership in the field as trainees receive less exposure to transport medicine. This study identifies the priorities of pediatric subspecialty fellows, fellowship directors and nursing directors in transport medicine education.
Internet based surveys were distributed to fellows, fellowship directors and nursing directors of transport teams affiliated with ACGME-approved fellowships in Neonatal-Perinatal Medicine (NPM), Pediatric Critical Care Medicine (PCCM), and Pediatric Emergency Medicine (PEM). Data collection occurred November 2013 to March 2014.
Four hundred and sixty-six responses were collected (357 fellows, 82 directors, 27 nursing directors): Six curricular elements were ranked by respondents: Transport Physiology (TP), Medical Control (MC), Vehicle Safety (VS), Medicolegal Issues (ML), Medical Protocols (MP) and State and Federal Regulations (SFR). Fellows and fellowship directors were not significantly different: TP (p = 0.63), VS (p = 0.45), SFR (p = 0.58), ML (p = 0.07), MP (p = 0.98), and MC (p = 0.36). Comparison of subspecialties found significant differences: PEM considered TP less important than NPM and PCCM (p < 0.001, p < 0.001), VS less important than NPM (p = 0.001). PEM viewed SFR and MC more important than PCCM (p = 0.006, p = 0.002); ML more important than PCCM and NPM (p = 0.001, p < 0.001). PCCM ranked MC more important than NPM (p = 0.004). Nursing directors considered TP less important than NPM and PCCM (p < 0.001, p = 0.002).
When ranking curricular elements in transport medicine, fellows and fellowship directors do not differ, but comparison of subspecialties notes significant differences. A fellow curriculum in transport medicine will utilize these results.
将重症患者转运至儿童医院是当前医疗实践的重要环节。美国儿科学会运输医学分会对该领域未来的领导力表示担忧，因为实习生接触运输医学的机会较少。本研究确定了儿科亚专业住院医师、住院医师培训项目主任和护理主任在运输医学教育方面的优先事项。
通过互联网向与美国研究生医学教育认证委员会（ACGME）认可的新生儿 - 围产期医学（NPM）、儿科重症医学（PCCM）和儿科急诊医学（PEM）住院医师培训项目相关的运输团队的住院医师、培训项目主任和护理主任发放调查问卷。数据收集时间为2013年11月至2014年3月。
共收集到466份回复（357名住院医师、82名主任、27名护理主任）。受访者对六个课程要素进行了排序：运输生理学（TP）、医疗控制（MC）、车辆安全（VS）、法医学问题（ML）、医疗协议（MP）以及州和联邦法规（SFR）。住院医师和培训项目主任之间无显著差异：TP（p = 0.63）、VS（p = 0.45）、SFR（p = 0.58）、ML（p = 0.07）、MP（p = 0.98）和MC（p = 0.36）。亚专业之间的比较发现存在显著差异：PEM认为TP不如NPM和PCCM重要（p < 0.001，p < 0.001），VS不如NPM重要（p = 0.001）。PEM认为SFR和MC比PCCM更重要（p = 0.006，p = 0.002）；ML比PCCM和NPM更重要（p = 0.001，p < 0.001）。PCCM将MC排在比NPM更重要的位置（p = 0.004）。护理主任认为TP不如NPM和PCCM重要（p < 0.001，p = 0.002）。
在对运输医学课程要素进行排序时，住院医师和培训项目主任没有差异，但亚专业之间的比较存在显著差异。运输医学住院医师课程将利用这些结果。
