麻醉学中的远程医疗：利用模拟教学进行远程术前评估

Telemedicine in Anesthesiology: Using Simulation to Teach Remote Preoperative Assessment.

作者信息

Watt Stacey A, Berger Roseanne C, Hirshfield Laura E, Yudkowsky Rachel

机构信息

The following authors are at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY: is Clinical Professor of Anesthesiology; is Associate Professor of Family Medicine.

The following authors are at the The University of Illinois College of Medicine at Chicago: is Associate Professor of Medical Education; is Professor and Director of Graduate Studies Department of Medical Education.

出版信息

J Educ Perioper Med. 2023 Jan 1;25(1):E699. doi: 10.46374/volxxv_issue1_watt. eCollection 2023 Jan-Mar.

DOI:10.46374/volxxv_issue1_watt

PMID:36960032

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10029111/

Abstract

BACKGROUND

The move toward telemedicine has markedly accelerated with the COVID-19 pandemic. Anesthesia residents must learn to provide preoperative assessments on a virtual platform. We created a pilot telemedicine curriculum for postgraduate year-2 (PGY2) anesthesiology.

METHODS

The curriculum included a virtual didactic session and a simulated virtual preoperative assessment with a standardized patient (SP). A faculty member and the SP provided feedback using a checklist based on the American Medical Association Telehealth Visit Etiquette Checklist and the American Board of Anesthesiology Applied Examination Objective Structured Clinical Examination content outline. Residents completed surveys assessing their perceptions of the effectiveness and helpfulness of the didactic session and simulated encounter, as well as the cognitive workload of the encounter.

RESULTS

A total of 12 PGY2 anesthesiology residents in their first month of clinical anesthesia residency training participated in this study. Whereas most (11/12) residents felt or in being able to conduct a telemedicine preoperative assessment after the didactic session, only 42% ensured adequate lighting and only 33% ensured patient privacy before conducting the visit. Postencounter survey comments indicated that the SP encounter was of greater value (more effective and helpful) than the didactic session. Residents perceived the encounter as demanding, but they felt successful in accomplishing it and did not feel rushed. Faculty and SP indicated that the checklist guided them in providing clear and useful formative feedback.

CONCLUSIONS

A virtual SP encounter can augment didactics to help residents learn and practice essential telemedicine skills for virtual preoperative assessments.

摘要

背景

随着新冠疫情的爆发，远程医疗的发展显著加速。麻醉科住院医师必须学会在虚拟平台上进行术前评估。我们为麻醉学专业研究生二年级（PGY2）创建了一个远程医疗试点课程。

方法

该课程包括一次虚拟理论授课以及与标准化病人（SP）进行的模拟虚拟术前评估。一名教员和标准化病人根据美国医学协会远程医疗就诊礼仪清单和美国麻醉学委员会应用考试客观结构化临床考试内容大纲，使用一份清单提供反馈。住院医师完成了多项调查，评估他们对理论授课和模拟问诊的有效性及实用性的看法，以及问诊时的认知工作量。

结果

共有12名处于临床麻醉住院医师培训首月的PGY2麻醉科住院医师参与了本研究。尽管大多数（11/12）住院医师在理论授课后感觉有能力或有信心进行远程医疗术前评估，但只有42%的人在问诊前确保了充足的照明，只有33%的人确保了患者隐私。问诊后的调查评论表明，与标准化病人的问诊比理论授课更有价值（更有效且更有帮助）。住院医师认为问诊要求较高，但他们觉得成功完成了问诊，且没有感到匆忙。教员和标准化病人表示，清单指导他们提供了清晰且有用的形成性反馈。