O'Brien D K, Flood J, Wesley R
Department of Family Practice, Southern Illinois University, School of Medicine, Springfield 62708.
Fam Pract Res J. 1987 Fall;7(1):42-50.
Utilization of a selected set of laboratory tests in the ambulatory setting was determined for four classes of family practice residents over their entire three year training program. A total of nineteen residents were included in the study. Residents' test utilization in their third year of training was significantly lower than in their Post Graduate Year I (PGY I) and PGY II years. Though there was a substantial drop in residents' utilization between their first and second year, the drop was not significant. While most residents reduced their test utilization as they progressed through residency, several who were extremely low utilization in there first year of training actually increase test utilization in the second year. There was substantial variation in residents' test utilization, most marked in the first year but persisting for all three years. Although test utilization progressively fell through the three years of training, the residents who were high utilizers during their first year of training remained high utilizers for the remainder of their training. Though the variation in resident test utilization apparent in PGYI was maintained throughout residency, the degree of variation was reduced and greater uniformity was achieved as training progressed.
在整个三年培训项目中，针对四类家庭医学住院医师，确定了在门诊环境中使用一组选定实验室检查的情况。该研究共纳入了19名住院医师。住院医师在培训第三年的检查使用率显著低于研究生一年级（PGY I）和研究生二年级（PGY II）。虽然住院医师在第一年和第二年之间的使用率大幅下降，但降幅并不显著。虽然大多数住院医师在住院期间随着时间推移降低了检查使用率，但在第一年检查使用率极低的几名住院医师在第二年实际增加了检查使用率。住院医师的检查使用率存在很大差异，最明显的是在第一年，但在所有三年中都持续存在。尽管在三年培训期间检查使用率逐渐下降，但在培训第一年检查使用率高的住院医师在剩余培训期间仍保持高使用率。虽然在PGY I中明显的住院医师检查使用率差异在整个住院期间都持续存在，但随着培训的推进，差异程度降低，实现了更大的一致性。
