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尚未成为医生,但我应该帮忙吗?一项对医学生应对公共领域发生的医疗紧急情况的态度的定性探索。

Not quite a doctor, but should I help? A qualitative exploration of medical students' attitudes towards responding to medical emergencies that occur in the public domain.

机构信息

Research Department of Primary Care and Population Health, University College London, London, UK.

出版信息

BMJ Open. 2019 Apr 8;9(4):e028035. doi: 10.1136/bmjopen-2018-028035.

Abstract

OBJECTIVE

To explore medical students' views on and experiences of responding to out-of-hospital medical emergencies.

SETTING

University College London (UCL).

PARTICIPANTS

11 UCL Medical School students.

STUDY DESIGN

Qualitative.

METHODS AND OUTCOME MEASURES

We carried out 11 one-to-one semistructured interviews, with participant validation and reflective work. The data were analysed using thematic analysis.

RESULTS

Three core themes were identified. (1) 'We Did Debate a Bit: Should We Go? Should We Not?'-Students' decisions to respond were based on the appearance of the casualty; the presence and actions of bystanders; witnessing the incident; self-perceived competence, confidence and knowledge; and personal experiences and feelings associated with medical emergencies. (2) 'It Would Represent the Medical Profession Well if We Did Step In and Help'-Students felt that they had an ethical and/or professional duty to help. (3) 'No One Should Die Because of a Lack of… Basic Life-Saving Techniques'-Students felt that medical school training alone had not sufficiently prepared them to respond to out-of-hospital medical emergencies. Improvements to training were suggested: integrating first aid/response training into the horizontal (systems-based) modules; teaching both common and less common medical emergencies and presentations; training that is led by experienced first responders and that increases students' exposure to out-of-hospital medical emergencies; and providing more revision training sessions.

CONCLUSIONS

Students felt that medical school training could be improved to better prepare them for responding to out-of-hospital medical emergencies, and wanted clarification on whether or not they have an ethical and/or professional duty to help. Further mixed-methods research using a larger sample needs to be carried out to confirm whether findings are transferable to other UK medical schools.

摘要

目的

探讨医学生对院外医疗急救的看法和应对经验。

地点

伦敦大学学院(UCL)。

参与者

UCL 医学院 11 名学生。

研究设计

定性研究。

方法和结果测量

我们进行了 11 次一对一的半结构式访谈,参与者进行了验证和反思。使用主题分析对数据进行分析。

结果

确定了三个核心主题。(1)“我们确实有过一些争论:我们应该去吗?我们不应该去吗?”-学生是否做出回应的决定基于伤者的外表、旁观者的存在和行动、目睹事件、自我感知的能力、信心和知识,以及与医疗急救相关的个人经历和感受。(2)“如果我们介入并提供帮助,这将代表医疗行业的良好形象”-学生认为他们有帮助的道德和/或职业责任。(3)“不应该因为缺乏……基本的救生技术而导致任何人死亡”-学生认为,仅通过医学院的培训还不足以让他们应对院外医疗急救。建议改进培训:将急救/应对培训纳入横向(基于系统)模块;教授常见和不常见的医疗急救和表现;由经验丰富的急救人员领导的培训,增加学生对院外医疗急救的接触;并提供更多复习培训课程。

结论

学生认为医学院的培训可以改进,以更好地为他们应对院外医疗急救做好准备,并希望澄清他们是否有帮助的道德和/或职业责任。需要进一步使用更大的样本进行混合方法研究,以确认研究结果是否可以推广到其他英国医学院。

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