Summe Alexa, Foor Laura, Hoeck Lauren, Campbell Kristen, Boyd Mark, Barnes Mary Ann
From the St Elizabeth Family Medicine Residency, Edgewood, Kentucky.
South Med J. 2018 Jun;111(6):344-347. doi: 10.14423/SMJ.0000000000000813.
The purpose of this study was to examine the impact telemedicine in the intensive care unit (ICU) has on the competency, satisfaction, and education of resident physicians.
Telemedicine in the ICU was implemented in 2014 at a community hospital with 24 family medicine residents. Comfort with the performance of various common procedures; management of major medical diseases in the ICU; and level of comfort, attitudes, and satisfaction in work relationships with various staff members in the ICU were assessed before and 1 year after the telemedicine implementation. This was done by the residents' respective training year and by all year groups combined. The Likert scores for each category were averaged by year group and by the three year groups combined, and these averages were compared pre- and posttelemedicine implementation using the test method.
All of the residents in the program participated voluntarily in the study, a 100% response rate. The results showed significant positive effects on resident education and satisfaction among ICU nurses and residents after the implementation of telemedicine-ICU. There were negative effects on residents' learning opportunities with the family medicine attending physicians, feelings of being a valued team member, and comfort with ventilator management.
Telemedicine-ICU implementation had mixed effects on residents' perceptions of their ICU experience and training. Further studies should be conducted to assess how to maximize resident training in this setting.
本研究旨在探讨重症监护病房（ICU）中的远程医疗对住院医师的能力、满意度及教育情况的影响。
2014年，一家拥有24名家庭医学住院医师的社区医院实施了ICU远程医疗。在远程医疗实施前及实施后1年，评估住院医师对各种常见操作的熟练程度、ICU中主要内科疾病的管理能力，以及他们在与ICU各科室工作人员的工作关系中的舒适度、态度和满意度。评估按住院医师各自的培训年份以及所有年份组综合进行。各类别李克特评分按年份组及三个年份组合并后的情况进行平均，采用检验方法对远程医疗实施前后的这些平均值进行比较。
该项目中的所有住院医师均自愿参与研究，回应率达100%。结果显示，实施ICU远程医疗后，对住院医师教育以及ICU护士和住院医师的满意度有显著积极影响。但对住院医师与家庭医学主治医师的学习机会、作为有价值团队成员的感受以及对呼吸机管理的熟练程度有负面影响。
实施ICU远程医疗对住院医师对其ICU经历和培训的认知产生了好坏参半的影响。应开展进一步研究，以评估如何在此环境中最大限度地提高住院医师培训效果。
