区域麻醉与急性疼痛医学进修项目中学员学习与教育课程的评估与分析：一项前瞻性观察性试点研究
Evaluation and Analysis of Fellow Learning and Education Curriculum in a Regional Anesthesiology and Acute Pain Medicine Fellowship: A Prospective, Observational Pilot Study.
作者信息
Klosowski Maciej Z, Schott Nicholas J
机构信息
is a 2020-2021 Regional Anesthesiology and Acute Pain Medicine fellow in the Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
is an Assistant Professor and Site Director in the Division of Acute Pain and Regional Anesthesia, University of Pittsburgh Medical Center Magee-Womens Hospital and also a Program Director for the Regional Anesthesiology and Acute Pain Medicine Fellowship, Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
出版信息
J Educ Perioper Med. 2022 Jan 1;24(1):E682. doi: 10.46374/volxxiv_issue1_schott. eCollection 2022 Jan-Mar.
BACKGROUND
Since 2017, several regional anesthesiology and acute pain medicine fellowship programs throughout the country have developed various educational didactic curriculums to address the core medical knowledge requirements as set by the Accreditation Council for Graduate Medical Education. Given the paucity of existing literature regarding the medical knowledge acquisition of regional anesthesiology and acute pain medicine fellows, this study aimed to determine how quickly these fellows learn during their fellowship year, with a secondary aim of analyzing a new educational didactic curriculum in its goal of delivering the required medical knowledge.
METHODS
An 89-question, multiple-choice examination was administered to the 2020-2021 regional anesthesiology and acute pain medicine fellows at the University of Pittsburgh Medical Center during orientation and again at 4 months and 8 months into the fellowship. A secondary analysis of anonymous deidentified answers was completed.
RESULTS
Fellows averaged 64%, 74%, and 79% correct responses on the orientation, 4-month, and 8-month exams, respectively. An analysis of the orientation exam revealed that the most commonly incorrect answers stemmed from topics including lower extremity nerve blocks, truncal blocks, and neuraxial anesthesia. The 4-month exam showed overall marked improvement; however, truncal blocks remained the most missed topic. Topics with 100% correct response rates in all examinations were local anesthetic pharmacology and systemic opioids.
CONCLUSIONS
The results of this study indicate that a large portion of learning occurs during the first 4 months of the fellowship and slows thereafter. Using this simple form of fellowship evaluation, changes to an educational didactic curriculum can be implemented to reach medical knowledge goals more effectively and efficiently as required by the Accreditation Council for Graduate Medical Education.
背景
自2017年以来，全国多个区域麻醉与急性疼痛医学 fellowship 项目制定了各种教育教学课程，以满足研究生医学教育认证委员会设定的核心医学知识要求。鉴于现有关于区域麻醉与急性疼痛医学 fellowship学员医学知识获取的文献匮乏，本研究旨在确定这些学员在 fellowship 年期间学习的速度有多快，其次要目的是分析一种新的教育教学课程在实现所需医学知识目标方面的情况。
方法
在匹兹堡大学医学中心，于入职培训时以及 fellowship 开始后的4个月和8个月，对2020 - 2021年区域麻醉与急性疼痛医学 fellowship学员进行了一次包含89道题的多项选择题考试。对匿名的去识别化答案进行了二次分析。
结果
学员在入职培训考试、4个月考试和8个月考试中的平均正确回答率分别为64%、74%和79%。对入职培训考试的分析表明，最常答错的答案来自包括下肢神经阻滞、躯干阻滞和椎管内麻醉等主题。4个月考试显示总体有显著进步；然而，躯干阻滞仍然是答错最多的主题。在所有考试中正确回答率达100%的主题是局部麻醉药理学和全身性阿片类药物。
结论
本研究结果表明，大部分学习发生在 fellowship 的前4个月，此后学习速度放缓。通过这种简单的 fellowship 评估形式，可以对教育教学课程进行调整，以更有效且高效地实现研究生医学教育认证委员会要求的医学知识目标。
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