初级住院医师处理重病和重伤儿童的能力：是时候重新思考我们当前的培训方法了？

Competencies of junior medical doctors in managing seriously ill and injured children: time to rethink our current training approach?

机构信息

Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7505, South Africa.

出版信息

J Trop Pediatr. 2023 Aug 24;69(4). doi: 10.1093/tropej/fmad025.

DOI:10.1093/tropej/fmad025

PMID:37672804

Abstract

BACKGROUND

The correct treatment of very ill and injured children is critical, yet little is known about the competencies of South African (SA) junior doctors in managing these children.

METHODS

This survey documents SA junior doctors' reported resuscitation training opportunities, experience, skills and knowledge.

RESULTS

A total of 118 doctors (interns, medical officers and registrars) from paediatric departments affiliated with 7 medical schools, participated. Resuscitations were not rare events with 71% (84/118) reporting participation in >10 resuscitations during the preceding 2 years. Yet a third of doctors have not attended an accredited resuscitation training course within the last 2 years; 34% (12/35) medical officers and 29% (18/63) registrars, respectively, with 42% (49/118) of all participants never receiving any formal resuscitation training during employment. Feedback on performance is not standard practice with only 8% (10/118) reporting consistent debriefing after a resuscitation. Although 72% (85/118) reported their resuscitation knowledge as adequate, 56% (66/118) passed the knowledge test.

CONCLUSION

This study recognized missed learning opportunities in junior doctors' training, assessment, debriefing and knowledge which may adversely affect the quality of care in managing paediatric emergencies. This has implications for departmental and post-graduate training programmes.

摘要

背景

正确治疗病重和受伤的儿童至关重要，但人们对南非初级医生管理这些儿童的能力知之甚少。

方法

本调查记录了南非初级医生报告的复苏培训机会、经验、技能和知识。

结果

共有来自 7 所医学院附属儿科的 118 名医生（实习医生、住院医师和住院医师）参与了这项调查。复苏并不罕见，71%（84/118）的医生报告在过去 2 年内参与了>10 次复苏。然而，三分之一的医生在过去 2 年内没有参加过认可的复苏培训课程；分别有 34%（12/35）的住院医师和 29%（18/63）的住院医师，42%（49/118）的所有参与者在工作期间从未接受过任何正规的复苏培训。反馈并不是标准做法，只有 8%（10/118）的医生报告在复苏后有一致的讨论。尽管 72%（85/118）的医生报告他们的复苏知识足够，但只有 56%（66/118）通过了知识测试。