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学员在新生儿复苏期间接受的监督量是可变的,并且通常取决于主观标准。

The amount of supervision trainees receive during neonatal resuscitation is variable and often dependent on subjective criteria.

机构信息

Indiana University School of Medicine, 699 Riley Hospital Drive, RR208, Indianapolis, IN, 46202, USA.

出版信息

J Perinatol. 2018 Aug;38(8):1081-1086. doi: 10.1038/s41372-018-0137-4. Epub 2018 May 24.

Abstract

OBJECTIVE

Measure variation in delivery room supervision provided by neonatologists using hypothetical scenarios and determine the factors used to guide entrustment decisions.

STUDY DESIGN

A survey was distributed to members of the American Academy of Pediatrics Section on Perinatal Pediatrics. Neonatologists were presented with various newborn resuscitation scenarios and asked to choose the level of supervision they thought appropriate and grade factors on their importance in making entrustment decisions.

RESULTS

There was significant variation in supervision neonatologists deemed necessary for most scenarios (deviation from the mode 0.36-0.69). Post-graduate year of training and environmental circumstances influence the amount of autonomy neonatologists grant trainees. Few neonatologists have objective assessment of a trainees' competence in neonatal resuscitation available to them and most never document how the trainee performed.

CONCLUSION

Delivery room supervision is often determined by subjective evaluation of trainees' competence and may not provide a level of supervision congruent with their capability.

摘要

目的

通过假设情景衡量新生儿科医生在产房提供的监督差异,并确定指导委托决策的因素。

研究设计

向美国儿科学会围产儿医学分会的成员分发了一份调查。新生儿科医生被介绍了各种新生儿复苏场景,并被要求选择他们认为合适的监督水平,并对在做出委托决策时的重要性进行分级。

结果

对于大多数情景(偏离模式 0.36-0.69),新生儿科医生认为需要的监督存在显著差异。研究生年资和环境情况影响新生儿科医生给予学员的自主权程度。很少有新生儿科医生能够对学员在新生儿复苏方面的能力进行客观评估,而且大多数人从未记录学员的表现。

结论

产房监督通常取决于对学员能力的主观评估,可能无法提供与学员能力相符的监督水平。

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本文引用的文献

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Lies, Damned Lies, and Surveys.谎言、该死的谎言与调查。
J Grad Med Educ. 2017 Dec;9(6):677-679. doi: 10.4300/JGME-D-17-00698.1.
2
How to Create a Bad Survey Instrument.如何设计一份糟糕的调查问卷。
J Grad Med Educ. 2017 Aug;9(4):411-415. doi: 10.4300/JGME-D-17-00375.1.
3
Entrustment Decision Making in Clinical Training.临床培训中的委托决策制定
Acad Med. 2016 Feb;91(2):191-8. doi: 10.1097/ACM.0000000000001044.
7
Predicting neonatal intubation competency in trainees.预测学员新生儿插管能力。
Pediatrics. 2015 May;135(5):e1229-36. doi: 10.1542/peds.2014-3700. Epub 2015 Apr 6.

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