Do as I say and not as I do: Surgical critical care program directors and diplomates shape the future.

IF 2.9 2区 医学 Q2 CRITICAL CARE MEDICINE
Tyler J Jones, Carol L Barry, Kimberly A Davis, Niels D Martin, Caroline O Prendergast, Thomas K Duncan, Amy N Hildreth, Kenji Inaba, Aaron R Jensen, Andrew T Jones, Steven L Moran, Tina L Palmieri, Nicole A Stassen, Krista L Kaups, Deborah M Stein
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引用次数: 0

Abstract

Background: In 1987, the Trauma, Burn, Surgical Critical Care Specialty Board of the American Board of Surgery began offering certification in surgical critical care (SCC). The blueprint for the certifying examination (CE) has changed little since then. The Trauma, Burn, Surgical Critical Care Specialty Board sought to modernize the content of the CE. A draft blueprint was vetted with SCC program directors (PDs) and diplomates to determine how frequently the proposed topics should be tested and how frequently these topics were encountered in clinical practice. The purpose of the study was to evaluate the importance placed on blueprint topics by SCC educators and practitioners, and their relevance to clinical practice.

Methods: Surgical critical care PDs and diplomates separately reviewed the blueprint and assessed the frequency topics should appear on the CE (4, annually; 3, biennially; 2, every few years; 1, never). Diplomates were also asked how frequently they encountered each topic in practice (4, daily; 3, weekly to monthly; 2, a few times/year; 1, never). Results were compared with t tests, and Cohen's d was calculated. A p value of <0.001 and a moderate effect size (d > 0.50) were used for significance.

Results: Response rates were 42% (n = 70) for PDs and 30% (n = 1307) for diplomates. A total of 188 topics were evaluated. Program directors requested more frequent assessment than diplomates in 28 categories (d's ranged from -0.51 to -0.87) with obstetrical emergencies and intensive care unit billing and coding being the most discordant. For 17 topics, diplomates expressed high discordance between the importance for testing and their current practice.

Conclusion: Surgical critical care practice has evolved significantly over the past 35 years. Modernization of the assessments used to measure knowledge should be aligned with practice but requires a balance of topics that are infrequently encountered but are exquisitely time-sensitive and life-threatening.

Level of evidence: Survey Study; Level IV.

照我说的做,不要照我做:外科重症监护项目主任和外交官塑造未来。
背景:1987年,美国外科委员会的创伤、烧伤、外科重症监护专业委员会开始提供外科重症监护认证(SCC)。自那以后,认证考试(CE)的蓝图几乎没有改变。创伤,烧伤,外科重症监护专业委员会试图使CE的内容现代化。蓝图草案由SCC项目主管(pd)和外交官审查,以确定建议的主题应该测试的频率以及这些主题在临床实践中遇到的频率。本研究的目的是评估SCC教育者和从业者对蓝图主题的重视程度,以及它们与临床实践的相关性。方法:外科危重症专科医生和专科医生分别审查蓝图并评估应在CE上出现的频率主题(每年4次;3、每两年;2、每隔几年;1,从来没有)。外交官们还被问及他们在实践中遇到每个话题的频率(每天4次;3、每周到每月;2、几次/年;1,从来没有)。结果与t检验比较,并计算Cohen’s d。p值为0.50)。结果:博士的应答率为42% (n = 70),文凭的应答率为30% (n = 1307)。总共评估了188个主题。在28个类别(d值范围从-0.51到-0.87)中,项目主任要求的评估频率高于专科医生,其中产科急诊和重症监护病房的计费和编码最不一致。对于17个议题,外交官们表达了测试的重要性与他们目前的做法之间的高度不一致。结论:外科重症监护实践在过去的35年中发生了显著的变化。用于衡量知识的评估的现代化应与实践保持一致,但需要平衡不经常遇到但具有高度时效性和危及生命的主题。证据水平:调查研究;IV级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.00
自引率
11.80%
发文量
637
审稿时长
2.7 months
期刊介绍: The Journal of Trauma and Acute Care Surgery® is designed to provide the scientific basis to optimize care of the severely injured and critically ill surgical patient. Thus, the Journal has a high priority for basic and translation research to fulfill this objectives. Additionally, the Journal is enthusiastic to publish randomized prospective clinical studies to establish care predicated on a mechanistic foundation. Finally, the Journal is seeking systematic reviews, guidelines and algorithms that incorporate the best evidence available.
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