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培训非重症医学科医生在重症监护病房与 COVID-19 患者一起工作。

Training non-intensivist doctors to work with COVID-19 patients in intensive care units.

机构信息

Copenhagen Academy for Medical Education and Simulation, Centre for Human Resources and Education, Copenhagen, Denmark.

Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.

出版信息

Acta Anaesthesiol Scand. 2021 May;65(5):664-673. doi: 10.1111/aas.13789. Epub 2021 Mar 3.

Abstract

BACKGROUND

Due to an expected surge of COVID-19 patients in need of mechanical ventilation, the intensive care capacity was doubled at Rigshospitalet, Copenhagen, in March 2020. This resulted in an urgent need for doctors with competence in working with critically ill COVID-19 patients. A training course and a theoretical test for non-intensivist doctors were developed. The aims of this study were to gather validity evidence for the theoretical test and explore the effects of the course.

METHODS

The 1-day course was comprised of theoretical sessions and hands-on training in ventilator use, hemodynamic monitoring, vascular access, and use of personal protective equipment. Validity evidence was gathered for the test by comparing answers from novices and experts in intensive care. Doctors who participated in the course completed the test before (pretest), after (posttest), and again within 8 weeks following the course (retention test).

RESULTS

Fifty-four non-intensivist doctors from 15 different specialties with a wide range in clinical experience level completed the course. The test consisted of 23 questions and demonstrated a credible pass-fail standard at 16 points. Mean pretest score was 11.9 (SD 3.0), mean posttest score 20.6 (1.8), and mean retention test score 17.4 (2.2). All doctors passed the posttest.

CONCLUSION

Non-intensivist doctors, irrespective of experience level, can acquire relevant knowledge for working in the ICU through a focused 1-day evidence-based course. This knowledge was largely retained as shown by a multiple-choice test supported by validity evidence. The test is available in appendix and online.

摘要

背景

由于预计需要机械通气的 COVID-19 患者数量激增,2020 年 3 月哥本哈根的 Rigshospitalet 将重症监护能力增加了一倍。这导致急需有能力治疗 COVID-19 重症患者的医生。为此开发了针对非重症监护医生的培训课程和理论考试。本研究的目的是为理论考试收集有效性证据,并探讨该课程的效果。

方法

为期 1 天的课程包括理论课程和呼吸机使用、血流动力学监测、血管通路以及个人防护设备使用的实践培训。通过比较重症监护方面的新手和专家的答案,为考试收集有效性证据。参加课程的医生在课前(预测试)、课后(后测试)和课程结束后 8 周内(保留测试)完成测试。

结果

来自 15 个不同专业的 54 名非重症监护医生参加了该课程,他们的临床经验水平参差不齐。该测试共包含 23 个问题,在 16 分处具有可信的及格/不及格标准。预测试平均得分为 11.9(SD 3.0),后测试平均得分为 20.6(1.8),保留测试平均得分为 17.4(2.2)。所有医生均通过了后测试。

结论

无论经验水平如何,非重症监护医生都可以通过为期 1 天的基于证据的集中课程获得在 ICU 工作的相关知识。多项选择题测试支持的有效性证据表明,这些知识得到了很好的保留。测试可在附录和网上获得。

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