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[西班牙神经科住院医师培训期间的24小时值班轮班:过去十年的变化]

[24-hour on-duty shifts during the training of neurology residents in Spain: changes in the last decade].

作者信息

Lambea-Gil A, Tejada-Meza H, Cerdán-Santacruz D M

机构信息

Instituto de Investigación Sanitaria (IIS) Aragón, Zaragoza, España.

Hospital Universitario Miguel Servet, Zaragoza, España.

出版信息

Rev Neurol. 2022 Nov 1;75(9):269-282. doi: 10.33588/rn.7509.2022096.

Abstract

INTRODUCTION

The neurology training program in Spain, approved in 2006, emphasizes the importance of residents' on-duty shifts supervised by a neurologist. An evaluation of the Specialty National Commission in 2008 showed an unequal fulfillment of this goal: 60.30% of the training units offered their residents 24-hour shifts with on-duty supervision, and only 43% in their own center. After more than a decade, and a new national training program on design, we would like to know the current situation and possible factors that might be involved.

MATERIAL AND METHODS

Cross-sectional study through self-administered surveys to neurology training units that had recently graduated residents (n = 77). Responses were collected between October 2021 and February 2022.

RESULTS

All units answered the survey. In 2021, 88.30% met the supervision objectives, and 83% offered their trainees 24-hour on-duty shifts with a neurologist in their center. Among related factors, there is a significant direct relationship between this kind of shift, the hospital's size, and the existence of a stroke unit.

DISCUSSION

Residents' guidance during the 24-hour neurology on-duty shifts follows the path set by the training program and the national commission. However, there are still some differences that go beyond purely healthcare aspects. The future national program could establish new guidelines that help us achieve less heterogeneity, in order to offer the same training in the assessment of acute neurological patients.

摘要

引言

西班牙于2006年批准的神经病学培训计划强调了由神经科医生监督住院医师值班轮班的重要性。2008年专业国家委员会的一项评估显示,这一目标的实现情况并不均衡:60.30%的培训单位为其住院医师提供了有值班监督的24小时轮班,而在其自身中心这一比例仅为43%。十多年后,在一项关于设计的新国家培训计划出台后,我们想了解当前的情况以及可能涉及的因素。

材料与方法

通过对近期有住院医师毕业的神经病学培训单位进行自行问卷调查的横断面研究(n = 77)。在2021年10月至2022年2月期间收集回复。

结果

所有单位都回答了调查。2021年,88.30%的单位达到了监督目标,83%的单位为其学员提供了中心有神经科医生的24小时值班轮班。在相关因素中,这种轮班、医院规模和卒中单元的存在之间存在显著的直接关系。

讨论

24小时神经病学值班期间住院医师的指导遵循培训计划和国家委员会设定的路径。然而,仍然存在一些超出纯粹医疗保健方面的差异。未来的国家计划可以制定新的指导方针,帮助我们减少异质性,以便在急性神经科患者评估中提供相同的培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d22/10280708/c4b7569aea4d/RN-75-269-g001.jpg

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