Department of Internal Medicine, Tripler Army Medical Center, Honolulu, HI (VMFM, CB).
Department of Pulmonary and Critical Care, Emory University, Atlanta, GA (AW).
Hawaii J Health Soc Welf. 2022 Aug;81(8):223-227.
The need for multidisciplinary teams to provide complex care has increased as the population ages. As these teams become increasingly integrated, the knowledge, skills, and attitudes of resident physicians to practice safe and effective care in intensive care units (ICUs) evolves. A structured and multidisciplinary orientation day for resident physicians was implemented to assess improvements in physician confidence at Tripler Army Medical Center in Hawai'i from July 2019 to June 2020. ICU residents received an orientation day from a multidisciplinary team, with an emphasis on practical knowledge for common disease processes in a system-based fashion and competency in procedural skills. A total of 30 residents were asked to complete a pre- and post- orientation survey over a 1-year period, with 17 pre and post surveys completed for a response rate of 57%. The survey measured residents' perceived confidence in various tasks. Scores were compared using a paired 2-sampled t-test to assess statistical significance. The majority of resident physicians (76%) had at least 1 month of prior ICU experience. Statistically significant improvement was seen in self-reported abilities in performing 6 of the 10 elements assessed. With the diverse pathophysiology in critical care, it was essential to create a broad orientation with didactic and simulation-based learning, which resulted in observed improvement in more than half of the areas of interest. Adopting an orientation day for resident physicians rotating through the ICU can improve resident physician confidence, review important knowledge and skills, and highlight the role of each contributing multidisciplinary team member.
随着人口老龄化，多学科团队提供复杂护理的需求不断增加。随着这些团队日益融合，住院医师在重症监护病房（ICU）实践安全有效的护理的知识、技能和态度也在不断发展。为了评估 2019 年 7 月至 2020 年 6 月在夏威夷的特里普陆军医疗中心住院医师信心的提高情况，对住院医师实施了结构化的多学科定向日活动。来自多学科团队的 ICU 住院医师接受了定向日培训，重点是系统地了解常见疾病过程的实用知识，并掌握程序性技能。在为期一年的时间里，共有 30 名住院医师被要求完成定向前后的调查，其中 17 名住院医师完成了定向前后的调查，回应率为 57%。该调查衡量了住院医师对各种任务的感知信心。使用配对 2 样本 t 检验比较分数，以评估统计学意义。大多数住院医师（76%）有至少 1 个月的 ICU 经验。在评估的 10 项内容中有 6 项，自我报告的能力有了显著提高。由于重症监护的病理生理学具有多样性，因此必须创建一个广泛的定向培训，包括理论和模拟学习，这使得超过一半的感兴趣领域都得到了显著的提高。为轮转 ICU 的住院医师举办定向日活动，可以提高住院医师的信心，复习重要的知识和技能，并突出每个多学科团队成员的作用。
