The Ohio State University College of Medicine, Department of Emergency Medicine, Columbus, Ohio.
West J Emerg Med. 2017 Jan;18(1):97-104. doi: 10.5811/westjem.2016.10.31275. Epub 2016 Nov 15.
The first formal orientation program for incoming emergency medicine (EM) residents was started in 1976. The last attempt to describe the nature of orientation programs was by Brillman in 1995. Now almost all residencies offer orientation to incoming residents, but little is known about the curricular content or structure of these programs. The purpose of this project was to describe the current composition and purpose of EM resident orientation programs in the United States.
In autumn of 2014, we surveyed all U.S. EM residency program directors (n=167). We adapted our survey instrument from one used by Brillman (1995). The survey was designed to assess the orientation program's purpose, structure, content, and teaching methods.
The survey return rate was 63% (105 of 167). Most respondents (77%) directed three-year residencies, and all but one program offered intern orientation. Orientations lasted an average of nine clinical (Std. Dev.=7.3) and 13 non-clinical days (Std. Dev.=9.3). The prototypical breakdown of program activities was 27% lectures, 23% clinical work, 16% skills training, 10% administrative activities, 9% socialization and 15% other activities. Most orientations included activities to promote socialization among interns (98%) and with other members of the department (91%). Many programs (87%) included special certification courses (ACLS, ATLS, PALS, NRP). Course content included the following: use of electronic medical records (90%), physician wellness (75%), and chief complaint-based lectures (72%). Procedural skill sessions covered ultrasound (94%), airway management (91%), vascular access (90%), wound management (77%), splinting (67%), and trauma skills (62%).
Compared to Brillman (1995), we found that more programs (99%) are offering formal orientation and allocating more time to them. Lectures remain the most common educational activity. We found increases in the use of skills labs and specialty certifications. We also observed increases in time dedicated to clinical work during orientation. Only a few programs reported engaging in baseline or milestone assessments, an activity that could offer significant benefits to the residency program.
1976 年首次为急诊医学（EM）住院医师举办了正式迎新培训计划。1995 年 Brillman 最后一次尝试描述迎新培训计划的性质。如今几乎所有住院医师培训计划都为新住院医师提供迎新培训，但对于这些培训计划的课程内容或结构知之甚少。本项目旨在描述美国急诊住院医师迎新培训计划的现状。
2014 年秋季，我们调查了美国所有急诊住院医师培训计划主任（n=167）。我们从 Brillman（1995）使用的工具中改编了我们的调查工具。该调查旨在评估迎新培训计划的目的、结构、内容和教学方法。
调查回复率为 63%（167 人中的 105 人）。大多数受访者（77%）负责为期三年的住院医师培训，除一个培训计划外，所有计划均提供实习迎新培训。迎新培训平均持续 9 个临床日（标准差=7.3）和 13 个非临床日（标准差=9.3）。典型的培训活动分为 27%的讲座、23%的临床工作、16%的技能培训、10%的行政活动、9%的社交活动和 15%的其他活动。大多数迎新培训包括促进实习住院医师之间（98%）和与部门其他成员之间（91%）社交的活动。许多培训计划（87%）包括特殊认证课程（ACLS、ATLS、PALS、NRP）。课程内容包括使用电子病历（90%）、医生健康（75%）和基于主诉的讲座（72%）。程序技能课程涵盖了超声检查（94%）、气道管理（91%）、血管通路（90%）、伤口管理（77%）、夹板固定（67%）和创伤技能（62%）。
与 Brillman（1995）相比，我们发现更多的培训计划（99%）正在提供正式迎新培训，并为此分配了更多的时间。讲座仍然是最常见的教学活动。我们发现技能实验室和专业认证的使用有所增加。我们还观察到迎新培训期间用于临床工作的时间增加。只有少数培训计划报告开展了基线或里程碑评估，这一活动可为住院医师培训计划带来显著益处。
