Latif Usma, Masear Courtney G, Schwengel Deborah A
J Educ Perioper Med. 2019 Apr 1;21(2):E620. eCollection 2019 Apr-Jun.
The impact of an online postgraduate year (PGY-1) education program on anesthesiology resident knowledge base, anxiety, or preparedness has not been described previously. The literature shows resident knowledge of perioperative care is lower than expected.
The Johns Hopkins Preoperative Evaluation and Anesthesia Course was designed as an 8 module, 8 month online academic curriculum for the program's PGY-1 class. Each module includes a pretest, topic synopsis, lecture video, moderated case discussion and a posttest. All PGY-1 residents entering the program in July 2012 were eligible to participate. Residents starting in July 2010 served as the control group. A survey was administered to measure self-assessed knowledge of and comfort with components of preoperative anesthesia care and perceived anxiety about starting the clinical anesthesia year. Additional outcome measures included performance on the pretest and postmodule tests and Anesthesia Knowledge Test scores from day 1 of Clinical Anesthesia year 1 (CA-1, PGY-2) orientation. Statistical analysis included independent t tests, the Mann-Whitney test, and sensitivity analyses.
Residents in the intervention group showed an improvement of 16.25 to 39.60 percentage points between the pretest and posttest in each of the 8 subjects (P < .0001 in every subject). The intervention group median score was 24 percentile points higher on the Anesthesia Knowledge Test as compared with the control group (P = .0488; lower 95% CI, 9.92). Significant improvement was also seen across measures including comfort advising about medications (P < .0001), understanding of coexisting disease (P < .0001), comfort assessing patient airway (P = .0002), and anxiety about starting PGY-2 year (P = .0116).
We have demonstrated significantly positive impact of a comprehensive, longitudinal online, asynchronous, multimodal educational intervention on PGY-1 residents using objective and subjective data.
此前尚未描述过在线研究生一年级(PGY-1)教育项目对麻醉住院医师知识库、焦虑情绪或准备情况的影响。文献表明,住院医师对围手术期护理的知识低于预期。
约翰·霍普金斯术前评估与麻醉课程被设计为一个针对该项目PGY-1班级的8模块、8个月的在线学术课程。每个模块包括一个预测试、主题概述、讲座视频、主持的病例讨论和一个后测试。所有于2012年7月进入该项目的PGY-1住院医师均有资格参与。2010年7月开始的住院医师作为对照组。进行了一项调查,以衡量对术前麻醉护理各组成部分的自我评估知识和舒适度,以及对开始临床麻醉学年的感知焦虑。其他结果指标包括预测试和模块后测试的表现,以及临床麻醉一年级(CA-1,PGY-2)入职第一天的麻醉知识测试分数。统计分析包括独立t检验、曼-惠特尼检验和敏感性分析。
干预组在8个主题中的每个主题的预测试和后测试之间显示出16.25至39.60个百分点的提高(每个主题P < .0001)。与对照组相比,干预组在麻醉知识测试中的中位数得分高24个百分点(P = .0488;95%置信区间下限,9.92)。在包括药物咨询舒适度(P < .0001)、对并存疾病的理解(P < .0001)、评估患者气道的舒适度(P = .0002)以及对开始PGY-2学年的焦虑(P = .0116)等指标上也观察到了显著改善。
我们已经通过客观和主观数据证明了一项全面、纵向的在线、异步、多模式教育干预对PGY-1住院医师具有显著的积极影响。