Department of Pediatrics, Division of Critical Care, Medical College of Wisconsin, Milwaukee, WI.
Department of Pediatrics, Division of Quantitative Health Sciences, Medical College of Wisconsin, Milwaukee, WI.
Pediatr Crit Care Med. 2018 Jul;19(7):643-648. doi: 10.1097/PCC.0000000000001548.
To assess the current training in brain death examination provided during pediatric critical care medicine fellowship.
Internet-based survey.
United States pediatric critical care medicine fellowship programs.
Sixty-four pediatric critical care medicine fellowship program directors and 230 current pediatric critical care medicine fellows/recent graduates were invited to participate.
Participants were asked demographic questions related to their fellowship programs, training currently provided at their fellowship programs, previous experience with brain death examinations (fellows/graduates), and perceptions regarding the adequacy of current training.
Twenty-nine program directors (45%) and 91 current fellows/graduates (40%) responded. Third-year fellows reported having performed a median of five examinations (interquartile range, 3-6). On a five-point Likert scale, 93% of program directors responded they "agree" or "strongly agree" that their fellows receive enough instruction on performing brain death examinations compared with 67% of fellows and graduates (p = 0.007). The responses were similar when asked about opportunity to practice brain death examinations (90% vs 54%; p < 0.001). In a regression tree analysis, number of brain death examinations performed was the strongest predictor of trainee satisfaction. Both fellows and program directors preferred bedside demonstration or simulation as educational modalities to add to the fellowship curriculum.
Pediatric critical care medicine fellows overall perform relatively few brain death examinations during their training. Pediatric critical care medicine fellows and program directors disagree in their perceptions of the current training in brain death examination, with fellows perceiving a need for increased training. Both program directors and fellows prefer additional training using bedside demonstration or simulation. Since clinical exposure to brain death examinations is variable, adding simulated brain death examinations to the pediatric critical care medicine fellowship curriculum could help standardize the experience.
评估儿科危重病医学住院医师培训中目前提供的脑死亡检查培训。
基于互联网的调查。
美国儿科危重病医学住院医师培训计划。
邀请了 64 名儿科危重病医学住院医师培训计划主任和 230 名现任儿科危重病医学住院医师/应届毕业生参加。
参与者被问及与他们的住院医师培训计划相关的人口统计学问题、他们的住院医师培训计划目前提供的培训、以前的脑死亡检查经验（住院医师/毕业生）以及对当前培训充足性的看法。
29 名主任（45%）和 91 名现任住院医师/毕业生（40%）做出了回应。三年级住院医师报告进行了中位数为 5 次检查（四分位距，3-6）。在五分制李克特量表上，93%的主任表示“同意”或“强烈同意”，他们的住院医师在进行脑死亡检查方面得到了足够的指导，而只有 67%的住院医师和毕业生表示同意（p=0.007）。当被问及进行脑死亡检查的机会时，回答也是类似的（90%比 54%；p<0.001）。在回归树分析中，进行脑死亡检查的次数是学员满意度的最强预测因素。住院医师和主任都更喜欢床边演示或模拟作为住院医师培训课程的补充教育模式。
儿科危重病医学住院医师在培训期间总体上进行的脑死亡检查相对较少。儿科危重病医学住院医师和主任在脑死亡检查的当前培训方面存在看法分歧，住院医师认为需要增加培训。主任和住院医师都更喜欢使用床边演示或模拟进行额外的培训。由于临床接触脑死亡检查的情况各不相同，因此在儿科危重病医学住院医师培训课程中增加模拟脑死亡检查可能有助于标准化经验。
