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儿科实习医生的心脏体格检查技能和听诊课程。

Cardiac Physical Exam Skills and Auscultation Session for Pediatric Interns.

机构信息

Assistant Professor, Department of Pediatrics, Washington University School of Medicine in St. Louis.

Associate Professor, Department of Pediatrics, Medical College of Wisconsin.

出版信息

MedEdPORTAL. 2022 Dec 20;18:11289. doi: 10.15766/mep_2374-8265.11289. eCollection 2022.

Abstract

INTRODUCTION

Physicians need adequate physical exam skills. Unfortunately, interns have variable physical exam skills, and teaching is often limited to rounds, an inconsistent setting. Physical exam skills, particularly those involving auscultation, require practice. Our goal was to create a cardiac physical exam workshop for pediatric interns that would improve their performance on an interactive assessment of their ability and understanding in physical exam and murmur interpretation.

METHODS

We completed a targeted needs assessment and then developed a 2-hour workshop on the pediatric cardiac physical exam targeted to pediatrics residents. The workshop included didactics, group discussion, and practice interpreting common pediatric murmurs. Pediatrics residents completed the assessment as a pretest and then participated in the workshop. At the end of the workshop, the assessment was administered as a posttest, followed by a reassessment 3 months later. Nonparametric statistical analysis was conducted. Pre- and posttest scores were compared using the Wilcoxon signed rank test.

RESULTS

Twenty-five residents completed the workshop, including 22 pediatrics residents, one pediatrics/anesthesia combined resident, one pediatric neurology resident, and one resident completing a preliminary year in pediatrics prior to dermatology residency. There was a significant increase in the mean score on the assessment from pre- to posttest (pretest = 54%, posttest = 71%, < .001). This increase was sustained at the 3-month reassessment ( = 67%).

DISCUSSION

This cardiac physical exam workshop demonstrated improvement in physical exam knowledge and interpretation ability as measured by an online pre-/posttest.

摘要

简介

医生需要掌握足够的体格检查技能。然而,实习医生的体格检查技能参差不齐,且教学通常仅限于床边教学,这是一种不一致的教学环境。体格检查技能,尤其是听诊技能,需要实践。我们的目标是为儿科实习医生创建一个心脏体格检查工作坊,以提高他们在体格检查和杂音解读方面的能力和理解的互动评估中的表现。

方法

我们完成了一项针对性的需求评估,然后为儿科住院医师开发了一个 2 小时的儿科心脏体格检查工作坊。该工作坊包括讲座、小组讨论和练习解读常见儿科杂音。儿科住院医师在参加工作坊之前完成评估。工作坊结束后,作为后测进行评估,然后在 3 个月后进行重新评估。采用非参数统计分析。使用 Wilcoxon 符号秩检验比较前后测得分。

结果

共有 25 名住院医师参加了工作坊,包括 22 名儿科住院医师、1 名儿科/麻醉联合住院医师、1 名儿科神经科住院医师和 1 名在皮肤科住院医师之前完成儿科预备年的住院医师。评估的平均分从前测到后测显著增加(前测=54%,后测=71%,<0.001)。这一增加在 3 个月后的重新评估中得以维持(=67%)。

讨论

这项心脏体格检查工作坊证明,在线前/后测中,体格检查知识和解释能力有所提高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8c3/9763479/3031d190a605/mep_2374-8265.11289-g001.jpg

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