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骨科住院医师处理现场损伤的准备情况与信心

Orthopaedic Resident Preparation and Confidence in Treating On-Field Injuries.

作者信息

Hodax Jonathan D, Sobel Andrew D, DeFroda Steven, Chambers Alison B, Hulstyn Michael J

机构信息

Department of Orthopaedics, Rhode Island Hospital, Providence, Rhode Island, USA.

Lifespan Biostatistics Core, Rhode Island Hospital, Providence, Rhode Island, USA.

出版信息

Orthop J Sports Med. 2017 May 31;5(5):2325967117708286. doi: 10.1177/2325967117708286. eCollection 2017 May.

Abstract

BACKGROUND

Orthopaedic surgery residents may cover athletic events, although the training provided to prepare residents for this role and oversight from attending physicians during these activities is not well understood.

PURPOSE

To survey orthopaedic residents about the training provided by their residency program for on-field athletic coverage and to understand their levels of preparation for this role and confidence in treating commonly encountered on-field conditions.

STUDY DESIGN

Descriptive epidemiology study.

METHODS

An anonymous survey was emailed to residents in all American College of Graduate Medical Education-accredited, allopathic, nonmilitary orthopaedic surgery residency programs. This survey queried residents about their demographics, the opportunities their residencies require or allow for athletic coverage, their level of preparation for serving an on-field physician, and their comfort level with treating a number of on-field conditions. Likert-type scales were used to assess resident comfort level for treating 13 orthopaedic and nonorthopaedic conditions as well as their perceived level of preparedness.

RESULTS

Of 148 residency programs contacted, 57 programs responded (39%). Of the 57 programs responding, 51 (89.5%) allowed or required residents to cover athletic events, and 27 of 51 (52.9%) reported that training to prepare for this role was provided. Only 6 of 24 programs without training available (25%) had direct attending supervision of residents at all athletic events. Residents who answered that their residency programs mandate training prior to their participation in athletic coverage activities reported a higher level of preparation for this role than those with no training, optional training, or those who were unsure of their training requirement ( < .0001, = .035, and = .013, respectively). In addition, the more senior the resident was, the higher the level of confidence was in treating all orthopaedic and some nonorthopaedic conditions. Residents who had mandatory training displayed a higher comfort level in treating on-field orthopaedic and nonorthopaedic conditions than those without training.

CONCLUSION

Formal training of orthopaedic residents prior to their covering athletic events can improve confidence in treating orthopaedic and nonorthopaedic conditions. Many programs do not ensure that residents are familiar with key and potentially life-saving equipment. An opportunity exists to improve resident education.

摘要

背景

骨科住院医师可能会参与体育赛事的医疗保障工作,然而,目前对于为使住院医师胜任这一角色所提供的培训以及在这些活动期间上级医师的监督情况,人们了解得并不充分。

目的

调查骨科住院医师接受其住院医师培训项目提供的现场体育赛事医疗保障培训的情况,了解他们对这一角色的准备程度以及处理常见现场伤病情况的信心。

研究设计

描述性流行病学研究。

方法

通过电子邮件向所有经美国毕业后医学教育认证委员会认证的、采用对抗疗法的、非军事性的骨科手术住院医师培训项目中的住院医师发送一份匿名调查问卷。该问卷询问了住院医师的人口统计学信息、其住院医师培训项目要求或允许参与体育赛事医疗保障的机会、担任现场医师的准备程度以及处理多种现场伤病情况的舒适度。采用李克特量表来评估住院医师处理13种骨科和非骨科伤病情况的舒适度以及他们自我感知的准备程度。

结果

在联系的148个住院医师培训项目中,有57个项目回复(39%)。在回复的57个项目中,51个(89.5%)允许或要求住院医师参与体育赛事的医疗保障工作,其中51个项目中有27个(52.9%)报告提供了为胜任这一角色而进行的培训。在24个未提供培训的项目中,只有6个(25%)在所有体育赛事中都有上级医师对住院医师进行直接监督。那些回答其住院医师培训项目要求他们在参与体育赛事医疗保障活动之前接受培训的住院医师,比起那些未接受培训、接受选择性培训或不确定培训要求的住院医师,报告称对这一角色的准备程度更高(分别为P <.0001、P = 0.035和P = 0.013)。此外,住院医师年级越高,处理所有骨科和一些非骨科伤病情况的信心就越高。接受强制性培训的住院医师在处理现场骨科和非骨科伤病情况时,比未接受培训的住院医师表现出更高的舒适度。

结论

骨科住院医师在参与体育赛事医疗保障之前接受正规培训,可以提高他们处理骨科和非骨科伤病情况的信心。许多项目并未确保住院医师熟悉关键且可能救命的设备。存在改进住院医师教育的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d6f/5455864/cdb09f87fe91/10.1177_2325967117708286-fig1.jpg

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