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聚焦夜间教育:住院医师和实习医生对现状、障碍及改进方法的看法

Shining a Light on Overnight Education: Hospitalist and Resident Impressions of the Current State, Barriers, and Methods for Improvement.

作者信息

Sani Sara N, Wistar Emily, Le Lien, Chia David, Haber Lawrence A

机构信息

Medicine, University of California San Francisco, San Francisco, USA.

Gastroenterology, University of California San Diego, San Diego, USA.

出版信息

Cureus. 2018 Jul 6;10(7):e2939. doi: 10.7759/cureus.2939.

Abstract

INTRODUCTION

Restrictions on resident work hours and increased requirements for resident supervision have led to night float rotations overseen by overnight hospitalists (nocturnists). The educational value of night float rotations for residents has traditionally been low and studies have yet to elucidate the optimal role of nocturnists in resident education.

METHODS

We performed a cross-sectional survey of all residents within our training program and attending hospitalists in the department of medicine at our three teaching medical centers. Questions sought to investigate the current state of overnight education within an internal medicine residency program, understand barriers to overnight education, and define best practices for nighttime teaching.

RESULTS

Both attending and resident physicians reported low satisfaction with the current state of overnight education, while simultaneously expressing high levels of interest in performing and receiving dedicated nighttime teaching. Attending and resident physicians identified similar barriers to overnight teaching (clinical work, time coordination, provider fatigue) and agreed on the ideal format for overnight didactics (case-based, chalk-talk, 20-minute duration between 10 pm to 2 am).

CONCLUSION

Our study identifies a desire by both faculty and trainees for increased overnight teaching and offers a simple initial framework for programs to improve overnight housestaff education utilizing nocturnist providers.

摘要

引言

对住院医师工作时长的限制以及对住院医师监督要求的提高,导致了由夜间医院医生(夜间值班医生)监督的夜间轮班制度。传统上,住院医师夜间轮班的教育价值较低,且研究尚未阐明夜间值班医生在住院医师教育中的最佳作用。

方法

我们对我们培训项目中的所有住院医师以及我们三个教学医学中心内科的主治医院医生进行了横断面调查。问题旨在调查内科住院医师培训项目中夜间教育的现状,了解夜间教育的障碍,并确定夜间教学的最佳实践方法。

结果

主治医生和住院医师都对当前夜间教育的现状表示不满,同时对进行和接受专门的夜间教学表现出高度兴趣。主治医生和住院医师确定了夜间教学的类似障碍(临床工作、时间协调、提供者疲劳),并就夜间教学的理想形式(基于病例、粉笔讲授、晚上10点至凌晨2点之间20分钟时长)达成一致。

结论

我们的研究表明教职员工和学员都希望增加夜间教学,并为项目提供了一个简单的初始框架,以利用夜间值班医生改善住院医师夜间教育。

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