在医学生麻醉学入门实习期间,在临床环境中制定和使用一套气管内麻醉诱导检查表评估。

Wendy T Nguyen, Mojca Remskar, Elena H Zupfer, Alex M Kaizer, Ilana R Fromer, Iryna Chugaieva, Benjamin Kloesel
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引用次数: 0

摘要

背景:美国医学院协会认为执行救生程序,如气道管理,是医学生过渡到住院医师的必要能力。麻醉学实习为医学生提供了一个独特的机会,让他们在一个安全可控的环境中实践这些程序。我们的目的是制定一份检查表,评估医学生在临床环境中执行气管插管全麻诱导主要步骤的能力。方法:我们创建了一个清单,其中包含与我们的办事员目标一致的项目。在收到反馈并在临床环境中进行试验后,我们对其进行了修改。采用实习前和实习后的研究设计,用检查表对医学生进行评估:(1)在实习开始时的模拟环境中;而(2)在手术室结束的见习工作。使用配对t检验,我们计算了实习前和实习后的核对表得分,以确定课程的有效性。结果的A P值:30名医学生参与研究。一致性的ICC为0.875(95%可信区间[CI], 0.704-0.944)。一致性的ICC为0.897 (95% CI, 0.795-0.950)。从基线到最终评估,评分有统计学意义上的显著改善,为3.6分(95% CI, 2.5-5.2;P = .001)。结论:检查表得分有统计学意义的变化,表明我们的医学生在诱导全身麻醉的入门实习中获得了知识和经验,并能够在临床环境中展示他们的知识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Development and Use of an Induction of General Endotracheal Anesthesia Checklist Assessment for Medical Students in a Clinical Setting During Their Introductory Anesthesiology Clerkship.

Development and Use of an Induction of General Endotracheal Anesthesia Checklist Assessment for Medical Students in a Clinical Setting During Their Introductory Anesthesiology Clerkship.

Background: The American Association of Medical Colleges deemed performing lifesaving procedures, such as airway management, a necessary medical student competency for transitioning to residency. Anesthesiology clerkships provide the unique opportunity for medical students to practice these procedures in a safe and controlled environment. We aimed to develop a checklist that assesses medical students' ability to perform the main steps of a general anesthesia induction with endotracheal intubation in the clinical setting.

Methods: We created a Checklist containing items aligned with our clerkship objectives. We modified it after receiving feedback and trialing it in the clinical setting. Medical students were evaluated with the Checklist using a pre- and post-clerkship study design: (1) in a simulation setting at the beginning of the clerkship; and (2) in the operating room at the end of the clerkship. Using paired t-tests, we calculated pre- and post-clerkship Checklist scores to determine curriculum efficacy. A P value of <.05 was determined to be statistically significant. We examined rater agreement between overall scores with intraclass correlation coefficients (ICC).

Results: Thirty medical students participated in the study. The ICC for agreement was 0.875 (95% confidence interval [CI], 0.704-0.944). The ICC for consistency was 0.897 (95% CI, 0.795-0.950). There was a statistically significant improvement in the score from baseline to final evaluation of 3.6 points (95% CI, 2.5-5.2; P = .001).

Conclusions: The statistically significant change in Checklist scores suggests that our medical students gained knowledge and experience during the introductory clerkship inducing general anesthesia and were able to demonstrate their knowledge in a clinical environment.

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