Montane Bryce, Abraham Abey, Bustamante Sergio, Vachharajani Tushar, Ayad Sabry, Devarajan Jagan, Thompson Dustin, Lee Ran, Rampersad Penelope, Gage Brian, Reznicek Emily, Luo Chongliang, Wardrop Richard
Internal Medicine, Washington University School of Medicine, St. Louis, USA.
Cardiothoracic Anesthesiology, Cleveland Clinic, Cleveland, USA.
Cureus. 2023 Sep 7;15(9):e44851. doi: 10.7759/cureus.44851. eCollection 2023 Sep.
This curriculum was designed to improve access to procedures for our internal medicine residents.
We created an interdisciplinary procedure course (IDPC) composed of two simulation sessions and a one-week procedural rotation supervised by multiple specialties including nephrology, cardiology, cardiothoracic anesthesiology, general anesthesiology, and interventional radiology. After the course, residents completed two surveys documenting the number of procedures and their level of confidence on a Likert scale (1 = very unconfident to 5 = very confident) prior to and after completing the curriculum.
Sixteen residents participated in the course from September 2021 to June 2022. The collective number of procedures performed by these 16 residents increased from 176 to 343 after a one-week rotation. For arterial lines, the proportion of residents that reported an improvement in confidence scores was 0.44 (95% confidence interval 0.23 to 1, p-value of 0.60). The proportion of residents that had an increase in their confidence performing central lines was 0.63 (95% confidence interval 0.39 to 1, p-value of 0.23). For intubations, the proportion of residents that reported an improvement in confidence was 0.94 (95% confidence interval 0.72 to 1, p-value of 0.0006).
By collaborating with multiple specialties, residents almost doubled the number of procedures performed during training and reported an increased level of confidence in procedural performance for airway intubation. We learned residents want to improve their access to procedures and described a curriculum that was easily implemented.
本课程旨在改善我们内科住院医师获得操作程序的机会。
我们创建了一个跨学科操作课程(IDPC),该课程由两次模拟课程和为期一周的操作轮转组成,由多个专业进行监督,包括肾病学、心脏病学、心胸麻醉学、普通麻醉学和介入放射学。课程结束后,住院医师完成了两项调查,记录了在完成课程之前和之后他们执行的操作数量以及他们在李克特量表(1 = 非常不自信至5 = 非常自信)上的自信程度。
从2021年9月到2022年6月,16名住院医师参加了该课程。在为期一周的轮转后,这16名住院医师执行的操作总数从176次增加到343次。对于动脉置管,报告自信得分有所提高的住院医师比例为0.44(95%置信区间为0.23至1,p值为0.60)。在进行中心静脉置管时自信增加的住院医师比例为0.63(95%置信区间为0.39至1,p值为0.23)。对于气管插管,报告自信有所提高的住院医师比例为0.94(95%置信区间为0.72至1,p值为0.0006)。
通过与多个专业合作,住院医师在培训期间执行的操作数量几乎增加了一倍,并报告在气道插管操作方面的自信程度有所提高。我们了解到住院医师希望改善他们获得操作程序的机会,并描述了一个易于实施的课程。