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跨学科危机资源管理培训:耳鼻喉科住院医师表现如何?一项调查研究。

Interdisciplinary Crisis Resource Management Training: How Do Otolaryngology Residents Compare? A Survey Study.

作者信息

Nhan Carol, Young Meredith, Bank Ilana, Nugus Peter, Fisher Rachel, Azzam Milène, Nguyen Lily H P

机构信息

Department of Otolaryngology-Head and Neck Surgery, McGill University, Montréal, Québec, Canada.

Center for Medical Education, McGill University, Montréal, Québec, Canada.

出版信息

OTO Open. 2018 May 14;2(2):2473974X18770409. doi: 10.1177/2473974X18770409. eCollection 2018 Apr-Jun.

Abstract

OBJECTIVE

Emergent medical crises, such as acute airway obstruction, are often managed by interdisciplinary teams. However, resident training in crisis resource management traditionally occurs in silos. Our objective was to compare the current state of interdisciplinary crisis resource management (IDCRM) training of otolaryngology residents with other disciplines.

METHODS

A survey study examining (1) the frequency with which residents are involved in interdisciplinary crises, (2) the current state of interdisciplinary training, and (3) the desired training was conducted targeting Canadian residents in the following disciplines: otolaryngology, anesthesiology, emergency medicine, general surgery, obstetrics and gynecology, internal medicine, pediatric emergency medicine, and pediatric/neonatal intensive care.

RESULTS

A total of 474 surveys were completed (response rate, 12%). On average, residents were involved in 13 interdisciplinary crises per year. Only 8% of otolaryngology residents had access to IDCRM training, as opposed to 66% of anesthesiology residents. Otolaryngology residents reported receiving an average of 0.3 hours per year of interdisciplinary training, as compared with 5.4 hours per year for pediatric emergency medicine residents. Ninety-six percent of residents desired more IDCRM training, with 95% reporting a preference for simulation-based training.

DISCUSSION

Residents reported participating in crises managed by interdisciplinary teams. There is strong interest in IDCRM and crisis resource management training; however, it is not uniformly available across Canadian residency programs. Despite their pivotal role in managing critical emergencies such as acute airway obstruction, otolaryngology residents received the least training.

IMPLICATION

IDCRM should be explicitly taught since it reflects reality and may positively affect patient outcomes.

摘要

目的

诸如急性气道梗阻等紧急医疗危机通常由跨学科团队进行处理。然而,住院医师在危机资源管理方面的培训传统上是各自为政的。我们的目的是比较耳鼻喉科住院医师与其他学科在跨学科危机资源管理(IDCRM)培训方面的现状。

方法

针对加拿大以下学科的住院医师开展了一项调查研究,调查内容包括:(1)住院医师参与跨学科危机的频率;(2)跨学科培训的现状;(3)期望的培训方式。这些学科包括:耳鼻喉科、麻醉学、急诊医学、普通外科、妇产科、内科、儿科急诊医学以及儿科/新生儿重症监护。

结果

共完成474份调查问卷(回复率为12%)。住院医师平均每年参与13次跨学科危机处理。只有8%的耳鼻喉科住院医师能够接受IDCRM培训,而麻醉科住院医师的这一比例为66%。耳鼻喉科住院医师报告称每年平均接受0.3小时的跨学科培训,而儿科急诊医学住院医师每年平均接受5.4小时的培训。96%的住院医师希望获得更多的IDCRM培训,95%的住院医师表示更喜欢基于模拟的培训。

讨论

住院医师报告参与了由跨学科团队管理的危机处理。对IDCRM和危机资源管理培训有浓厚兴趣;然而,在加拿大的住院医师培训项目中,这种培训并非普遍可得。尽管耳鼻喉科住院医师在处理诸如急性气道梗阻等危急紧急情况中起着关键作用,但他们接受的培训最少。

启示

应明确教授IDCRM,因为它反映了实际情况,可能对患者预后产生积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/243d/6239147/21ed56435ce1/10.1177_2473974X18770409-fig1.jpg

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