提高初级医生在创伤与骨科方面的准备程度和满意度：一项开发综合指南手册的质量改进项目
Enhancing Junior Doctors' Preparedness and Satisfaction in Trauma and Orthopaedics: A Quality Improvement Project With the Development of a Comprehensive Guidebook.
作者信息
Mohammed Ghulam Dastagir Faisal, Younis Zubair, Amin Jebran, Mansoor Zaina, Lingnau Leonie, Jesudason Edwin P
机构信息
Trauma and Orthopaedics, Ysbyty Gwynedd, Bangor, GBR.
Trauma and Orthopaedics, Royal Shrewsbury Hospital, Shrewsbury, GBR.
出版信息
Cureus. 2024 Sep 23;16(9):e70061. doi: 10.7759/cureus.70061. eCollection 2024 Sep.
BACKGROUND
Junior doctors often feel underprepared for their trauma and orthopaedics (T&O) rotation due to limited exposure during medical school and inadequate support. This project aimed to enhance junior doctors' preparedness and satisfaction during their T&O rotation by developing a comprehensive guidebook that addresses key orthopaedic knowledge and logistical challenges.
METHODS
A quality improvement project (QIP) was conducted at Ysbyty Gwynedd Hospital. Initial surveys identified factors contributing to poor experiences during the trauma and orthopaedics rotation, including limited knowledge of orthopaedic emergencies and a lack of useful reference resources. A guidebook was developed and refined through multiple plan-do-study-act (PDSA) cycles. The guidebook covered topics such as orthopaedic emergencies, common injuries, referral pathways, and hospital logistics, presented in an accessible flowchart format.
RESULTS
The primary objective of achieving 75% satisfaction among junior doctors was successfully met, with satisfaction increasing from four (40%) to eight (80%) doctors in the most recent survey. Secondary outcomes included a marked improvement in the understanding of quality improvement projects, rising from three (30%) to eight (80%) doctors. Orthopaedic knowledge also saw a significant enhancement, increasing from four (40%) to nine (90%) doctors. Confidence in handling night on-call duties improved dramatically, with all 10 doctors (100%) reporting increased confidence, compared to four (40%) doctors initially. Additionally, seven doctors (70%) expressed a greater interest in pursuing a career in orthopaedic surgery.
CONCLUSION
The comprehensive guidebook significantly improved junior doctors' preparedness and satisfaction during their T&O rotation. While the guidebook is a valuable resource, ongoing mentorship and hands-on experience remain essential for long-term success. Replication of this project across other departments and hospitals is recommended to assess its broader applicability and impact.
背景
由于在医学院期间接触有限且支持不足，初级医生在创伤与骨科（T&O）轮转时常常觉得准备不充分。本项目旨在通过编写一本涵盖关键骨科知识和后勤挑战的综合指南，提高初级医生在T&O轮转期间的准备程度和满意度。
方法
在格温内德医院开展了一项质量改进项目（QIP）。初步调查确定了导致创伤与骨科轮转体验不佳的因素，包括对骨科急症的了解有限以及缺乏有用的参考资源。通过多个计划-执行-研究-改进（PDSA）循环开发并完善了一本指南。该指南涵盖了骨科急症、常见损伤、转诊途径和医院后勤等主题，以易于理解的流程图形式呈现。
结果
成功实现了初级医生满意度达到75%的主要目标，在最近的调查中，满意度从4名（40%）医生提高到了8名（80%）医生。次要结果包括对质量改进项目的理解有显著提高，从3名（30%）医生增加到8名（80%）医生。骨科知识也有显著增强，从4名（40%）医生增加到9名（90%）医生。处理夜间值班职责的信心大幅提高，所有10名医生（100%）报告信心增强，而最初只有4名（40%）医生有此感受。此外，7名医生（70%）表示对从事骨科手术职业更感兴趣。
结论
这本综合指南显著提高了初级医生在T&O轮转期间的准备程度和满意度。虽然该指南是一项宝贵资源，但持续的指导和实践经验对于长期成功仍然至关重要。建议在其他科室和医院推广该项目，以评估其更广泛的适用性和影响。
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