Page David, Brazelton Tom, Kokx Gordon, Jennings Paul A, Williams Brett
Prehospital Care Research Forum University of California Los Angeles Los Angeles California USA.
Department of Paramedicine Monash University Melbourne Australia.
J Am Coll Emerg Physicians Open. 2021 Mar 2;2(2):e12391. doi: 10.1002/emp2.12391. eCollection 2021 Apr.
Paramedic students in the US are required to complete clinical placements to gain supervised experience with real patient encounters. Given wide variation in clinical placement practices, an evidence-based approach is needed to guide programs in setting realistic and attainable goals for students. This study's goal was to describe patient encounters and hours logged by paramedic students during clinical placements.
A retrospective review of prospectively collected quality assurance data entered by US paramedic students between 2010 and 2014 was conducted. De-identified electronic records entered in the Field Internship Student Data Acquisition Project (FISDAP) Skill Tracker database were included from consenting paramedic students whose records were audited and approved by instructors. Descriptive statistics were calculated.
A total of 10,645 students encountered 2,239,027 patients; most encounters occurred in hospital settings (n = 1,311,967, 59%). The median total number of patient encounters per paramedic student was 206 (142-269) and the median total clinical placement hours per student was 626 (504-752). The median number of team leads per student was 56 (30-84). Students encountered a median of 22 (12-31) pediatric patients, ages 0-12 years, and 181 (126-238) adolescent or adult patients. For pediatric patient encounters, the most common clinical impressions were respiratory distress, other medical complaints, and extremity trauma. Among adult patient encounters, the most common clinical impressions included other medical, trauma, and cardiac conditions.
US paramedic students experienced a variable range of patient encounter types and volumes. The findings of this study offer an evidence base from which programs can set realistic and attainable clinical placement requirements.
美国护理人员专业的学生需要完成临床实习，以获得在真实患者接触中的监督经验。鉴于临床实习实践存在很大差异，需要一种基于证据的方法来指导项目为学生设定现实且可实现的目标。本研究的目的是描述护理人员专业学生在临床实习期间接触的患者情况和记录的时长。
对2010年至2014年间美国护理人员专业学生前瞻性收集的质量保证数据进行回顾性分析。从同意参与且其记录经教师审核和批准的护理人员专业学生中，纳入输入到现场实习学生数据采集项目（FISDAP）技能跟踪数据库中的去识别电子记录。计算描述性统计数据。
共有10645名学生接触了2239027名患者；大多数接触发生在医院环境（n = 1311967，59%）。每名护理人员专业学生接触患者的总数中位数为206（142 - 269），每名学生临床实习总时长中位数为626（504 - 752）。每名学生担任团队负责人的次数中位数为56（30 - 84）。学生接触的儿科患者（0至12岁）中位数为22（12 - 31）名，青少年或成年患者中位数为181（126 - 238）名。对于儿科患者接触，最常见的临床诊断为呼吸窘迫、其他医疗主诉和肢体创伤。在成年患者接触中，最常见的临床诊断包括其他医疗状况、创伤和心脏疾病。
美国护理人员专业学生接触的患者类型和数量各不相同。本研究结果提供了一个证据基础，项目可据此设定现实且可实现的临床实习要求。
