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通过朋辈引导、实操模拟为初级放射科住院医师做好夜间值班准备。

Preparing junior radiology residents for overnight call via peer-led, hands-on simulation.

机构信息

The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolfe St. Room 118, Baltimore, MD, 21287, USA.

出版信息

Emerg Radiol. 2021 Jun;28(3):589-599. doi: 10.1007/s10140-020-01887-x. Epub 2021 Jan 16.

Abstract

PURPOSE

The aim of this study was to assess the perceived value and impact of a hands-on mock call simulation program on resident confidence with interpretation of emergency department overnight call cases.

METHODS

A five-session course was implemented in June of 2018 for rising PGY-3/R2 residents to mimic the experience of overnight call with indirect supervision. Sessions were led by senior residents in the program and consisted of timed, independent interpretation of 15-20 high-yield cases per day which highlighted "do-not miss" critical findings and simulated workflow interruptions including phone calls, consultations, and questions from technologists. IRB-approved, and anonymous pre- and post-course surveys were administered to participants which assessed residents' degree of confidence in interpretation of on-call cases and comparison of the mock call experience with existing preparatory strategies. Survey responses were analyzed using McNemar's test and Mann-Whitney U test.

RESULTS

Our survey response rate was 91% (29/32). After completing the mock call simulation, there was a significant increase in the mean Likert score of resident confidence levels and feelings of preparedness from 4.59 to 7.38 (p < 0.01). The majority of respondents (72.4% [21/29]) felt that the mock call simulation was "extremely useful." One hundred percent of respondents indicated that the mock call simulation should be implemented for the following year.

CONCLUSION

Implementation of a hands-on mock call simulation significantly improves the confidence levels of radiology residents before assuming on-call responsibilities and may serve as an adjunct to existing preparatory strategies.

摘要

目的

本研究旨在评估实践模拟呼叫模拟计划对住院医师对急诊科夜间呼叫病例解释的信心的感知价值和影响。

方法

2018 年 6 月,为即将升任 PGY-3/R2 的住院医师实施了一个五节课的课程,以模拟夜间间接监督的呼叫经验。课程由该计划的高级住院医师领导,包括每天独立、定时地解释 15-20 个高收益病例,突出强调“不容忽视”的关键发现,并模拟工作流程中断,包括电话、咨询和技术人员的问题。对参与者进行了 IRB 批准的匿名课前和课后调查,评估了住院医师对夜间呼叫病例解释的信心程度,并比较了模拟呼叫体验与现有准备策略。使用 McNemar 检验和 Mann-Whitney U 检验分析调查结果。

结果

我们的调查回复率为 91%(29/32)。完成模拟呼叫模拟后,住院医师的信心水平和准备感的平均 Likert 评分从 4.59 显著增加到 7.38(p < 0.01)。大多数受访者(72.4%[21/29])认为模拟呼叫模拟“非常有用”。100%的受访者表示应该为下一年实施模拟呼叫模拟。

结论

实施实践模拟呼叫模拟可以显著提高放射科住院医师在承担夜间值班责任前的信心水平,并且可以作为现有准备策略的辅助手段。

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