Kelley C, Edmonson M B, Pascoe J M
Department of Pediatrics, University of Wisconsin, Madison, USA.
Arch Pediatr Adolesc Med. 1997 May;151(5):511-4. doi: 10.1001/archpedi.1997.02170420081014.
To determine how and what pediatric residency programs are teaching residents about normal newborn care in the nursery.
A mailed survey distributed in 1994.
All 237 known pediatric residency programs in the United States, Canada, and Puerto Rico.
Survey response rate was 77% (184 of 237 questionnaires were returned and completed). In 40% of the programs, neonatologists were primarily responsible or co-responsible for teaching residents about management of normal newborns. A normal newborn nursery curriculum had been developed and implemented in 56% of the programs, 30% of programs were developing one, and 13% reported no curriculum. Specific instruction about breast-feeding was not offered in 16% of programs. Circumcisions were most commonly performed by obstetricians; anesthetic use was low (overall median use, 10%) but was more common (P < .002) when circumcisions were performed by pediatricians. The hospital environment and lack of faculty time were cited as the main barriers to teaching residents about normal newborn care.
Although general pediatricians spend a substantial amount of practice time on newborn care, neonatologists were responsible for this teaching in almost half of the pediatric residency programs. Many programs have not developed a curriculum. Instruction about breast-feeding was not universal. Most pediatric residents do not learn to perform circumcisions. General pediatricians should be more involved in the development, implementation, and evaluation of comprehensive newborn nursery curricula to improve training in this important aspect of general pediatric practice.
确定儿科住院医师培训项目如何以及向住院医师传授了哪些有关新生儿病房正常新生儿护理的知识。
1994年进行的邮寄调查。
美国、加拿大和波多黎各所有已知的237个儿科住院医师培训项目。
调查回复率为77%（共返回并完成了237份问卷中的184份）。在40%的项目中，新生儿科医生主要负责或共同负责向住院医师传授正常新生儿的管理知识。56%的项目已制定并实施了正常新生儿护理课程，30%的项目正在制定，13%的项目表示没有课程。16%的项目未提供关于母乳喂养的具体指导。包皮环切术最常由产科医生进行；麻醉剂的使用比例较低（总体中位数使用率为10%），但由儿科医生进行包皮环切术时更为常见（P < .002）。医院环境和教员时间不足被认为是向住院医师传授正常新生儿护理知识的主要障碍。
尽管普通儿科医生在新生儿护理方面花费了大量的执业时间，但在近一半的儿科住院医师培训项目中，新生儿科医生负责此项教学。许多项目尚未制定课程。关于母乳喂养的指导并不普遍。大多数儿科住院医师没有学习进行包皮环切术。普通儿科医生应更多地参与全面的新生儿护理课程的开发、实施和评估，以改善普通儿科实践这一重要方面的培训。
