Research Department of Primary Care and Population Health, University College London, London, UK.
BMJ Open. 2019 Apr 8;9(4):e028035. doi: 10.1136/bmjopen-2018-028035.
To explore medical students' views on and experiences of responding to out-of-hospital medical emergencies.
University College London (UCL).
11 UCL Medical School students.
Qualitative.
We carried out 11 one-to-one semistructured interviews, with participant validation and reflective work. The data were analysed using thematic analysis.
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.
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.
探讨医学生对院外医疗急救的看法和应对经验。
伦敦大学学院(UCL)。
UCL 医学院 11 名学生。
定性研究。
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。
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。
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。