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COVID-19 患者护理经验与日本住院医师的教育成就:一项基于普通医学住院医师培训考试的全国性调查。

Experience of caring for patients with COVID-19 and educational achievement among Japanese resident physicians: a nationwide survey with general medicine in-training examination.

机构信息

Department of Public Health, Yokohama City University, 1370-1 Okamoto, Yokohama, Kamakura City, Kanagawa Prefecture, 247-8533, Japan.

Department of General Internal Medicine, Shonan Kamakura General Hospital, Kamakura, Japan.

出版信息

BMC Med Educ. 2024 Oct 11;24(1):1125. doi: 10.1186/s12909-024-06085-8.

Abstract

BACKGROUND

As healthcare professional trainees, resident physicians are expected to help with COVID-19 care in various ways. Many resident physicians worldwide have cared for COVID-19 patients despite the increased risk of burnout. However, few studies have examined the experience with COVID-19 care among resident physicians and its effects on competency achievement regarding clinical basics and COVID-19 patient care.

METHOD

This nationwide, cross-sectional Japanese study used a clinical training environment questionnaire for resident physicians (PGY-1 and - 2) in 593 teaching hospitals during the General Medicine In-Training Examination in January 2021. The General Medicine In-Training Examination questions comprised four categories (medical interviews and professionalism; symptomatology and clinical reasoning; physical examination and clinical procedures; and disease knowledge) and a COVID-19-related question. We examined the COVID-19 care experience and its relationship with the General Medicine In-Training Examination score, adjusting for resident and hospital variables.

RESULTS

Of the 6,049 resident physicians, 2,841 (47.0%) had no experience caring for patients with COVID-19 during 2020. Total and categorical General Medicine In-Training Examination scores were not different irrespective of the experience with COVID-19 patient care. For the COVID-19-related question, residents with experience in COVID-19 care showed a significant increase in correct response by 2.6% (95% confidence interval, 0.3-4.9%; p = 0.028).

CONCLUSIONS

The resident physicians' COVID-19 care experience was associated with better achievement of COVID-19-related competency without reducing clinical basics. However, approximately half of the residents missed the critical experience of caring for patients during this unparalleled pandemic in Japan.

摘要

背景

作为医疗保健专业人员的受训者,住院医师应通过各种方式帮助应对 COVID-19。尽管面临倦怠风险增加的情况,但全球许多住院医师都照顾过 COVID-19 患者。然而,很少有研究调查住院医师在 COVID-19 护理方面的经验及其对临床基础知识和 COVID-19 患者护理方面的能力发展的影响。

方法

这项全国性的、横截面的日本研究在 2021 年 1 月的一般内科住院医师培训考试中,使用针对 593 所教学医院的住院医师(PGY-1 和 -2)的临床培训环境问卷。一般内科住院医师培训考试的问题包括四个类别(医学访谈和专业性;症状和临床推理;体检和临床操作;以及疾病知识)和一个与 COVID-19 相关的问题。我们调查了 COVID-19 护理经验及其与一般内科住院医师培训考试成绩的关系,同时调整了住院医师和医院变量。

结果

在 6049 名住院医师中,有 2841 名(47.0%)在 2020 年期间没有照顾 COVID-19 患者的经验。无论是否有 COVID-19 患者护理经验,总体和分类的一般内科住院医师培训考试成绩均无差异。对于与 COVID-19 相关的问题,有 COVID-19 护理经验的住院医师的正确回答率显著提高了 2.6%(95%置信区间,0.3-4.9%;p=0.028)。

结论

住院医师的 COVID-19 护理经验与更好地实现 COVID-19 相关能力相关,而不会降低临床基础知识。然而,在日本这场前所未有的大流行期间,大约有一半的住院医师错过了照顾患者的关键经验。

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