Pappas A A, Drew M J, Flick J, Fink L, Fuller G L, Hough A J
University Hospital of Arkansas, Little Rock 72205-7199.
Arch Pathol Lab Med. 1994 May;118(5):578-83.
An introductory 4-week orientation for clinical pathology is described. There were 76 hours of lectures, 74 hours of conferences, and 68 hours of laboratories for a total of 221 hours. During the orientation, all calls handled by the residents were evaluated as to resolution, patient outcome, and interaction required. Eighty calls were received during the orientation from 57 technologists (71%), 16 physicians (20%), and seven nurses (9%). The calls originated concerning the following: blood banking, 37 (46%); hematology, 21 (27%); chemistry, 14 (18%); microbiology, five (6%); and administration, three (4%). Sixty percent of the calls were consultative and 40% were supervisory. Ninety-nine percent were handled appropriately by the residents. Patient outcome was moderately or significantly affected in 44% of all calls, divided between 67% of all consultative calls and 9% of all supervisory calls. Significant pathologist interaction was required in 49% of all calls, divided between 71% of the consultative calls and 16% of the supervisory calls. Using this integrated, dynamic system of resident instruction, on-call experience, and evaluation, residents quickly gain confidence in handling call, didactic clinical consultation, and patient management. The orientation and on-call system described provides for a relevant and dynamic system for resident education.
本文介绍了一个为期4周的临床病理学入门培训。培训内容包括76小时的讲座、74小时的研讨会和68小时的实验室课程，共计221小时。在培训期间，对住院医师处理的所有呼叫进行了评估，评估内容包括解决情况、患者结局以及所需的互动。培训期间共收到80个呼叫，分别来自57名技术人员（71%）、16名医生（20%）和7名护士（9%）。呼叫涉及以下方面：血库，37个（46%）；血液学，21个（27%）；化学，14个（18%）；微生物学，5个（6%）；行政管理，3个（4%）。60%的呼叫为咨询性呼叫，40%为监督性呼叫。99%的呼叫由住院医师妥善处理。44%的所有呼叫对患者结局有中度或显著影响，其中咨询性呼叫占67%，监督性呼叫占9%。49%的所有呼叫需要病理学家进行显著互动，其中咨询性呼叫占71%，监督性呼叫占16%。通过这种将住院医师指导、值班经验和评估相结合的动态系统，住院医师能够迅速在处理呼叫、理论临床咨询和患者管理方面获得信心。所描述的培训和值班系统为住院医师教育提供了一个相关且动态的系统。
