Petroski Tara, Lawrence Lynn, Qiao Haiping, Wrotniak Brian H
From the John R. Oishei Hospital, Buffalo, NY.
Pediatr Emerg Care. 2020 Feb;36(2):87-91. doi: 10.1097/PEC.0000000000002041.
The aims of the study were to assess the feasibility of using low-cost models to train first-year pediatric residents and to examine whether residents who receive such training will be as competent as their experienced colleagues in performing 4 American College of Graduate Education-required procedures, including suturing, splinting, lumbar puncture, and venipuncture.
We performed a pilot study with postgraduate year (PGY) 1 to 3 residents. Postgraduate year 1 residents completed a self-assessment questionnaire before the onset of training. A lecture was given to all PGY levels residents about procedural techniques. The PGY-1 residents practiced these techniques on low-fidelity models immediately after the lecture. One and 9 months after the initial lecture, all residents were assessed on these models using a 10-point checklist for each skill.
Thirteen PGY-1 residents, 10 PGY-2 residents, and 10 PGY-3 residents completed the study. There was no statistically significant difference in performance of PGY-1 residents when compared with PGY-2 and PGY-3 residents in performing lumbar puncture, venipuncture, and suturing on models in the initial assessment that was performed 1 month after the lecture. Postgraduate year 1 residents performed equally well to PGY-3 residents and significantly (P < 0.05) better than PGY-2 residents, in splinting.There was no statistically significant difference between groups at final follow-up, supporting that training on models could help enhance proficiency among residents.
This pilot study supports the feasibility of using low-cost models to train residents on invasive and painful procedures. Furthermore, residents trained on models showed maintenance of skills for a 9-month period.
本研究旨在评估使用低成本模型培训一年级儿科住院医师的可行性,并检验接受此类培训的住院医师在执行美国研究生医学教育要求的四项操作(包括缝合、夹板固定、腰椎穿刺和静脉穿刺)时是否能与经验丰富的同事一样胜任。
我们对1至3年级的住院医师进行了一项试点研究。一年级住院医师在培训开始前完成了一份自我评估问卷。为所有年级的住院医师举办了一次关于操作技术的讲座。一年级住院医师在讲座结束后立即在低保真模型上练习这些技术。在初次讲座后的1个月和9个月,使用每项技能的10分清单对所有住院医师在这些模型上进行评估。
13名一年级住院医师、10名二年级住院医师和10名三年级住院医师完成了研究。在讲座后1个月进行的初次评估中,一年级住院医师在模型上进行腰椎穿刺、静脉穿刺和缝合操作时,与二年级和三年级住院医师相比,表现无统计学显著差异。在夹板固定方面,一年级住院医师的表现与三年级住院医师相当,且显著(P<0.05)优于二年级住院医师。在最终随访时,各组之间无统计学显著差异,这支持了在模型上进行培训有助于提高住院医师的熟练程度。
这项试点研究支持使用低成本模型培训住院医师进行侵入性和疼痛性操作的可行性。此外,在模型上接受培训的住院医师在9个月内保持了技能。