基于混合模拟技术的急诊医师危重症抢救能力的评价研究

Evaluation of the emergency physicians'competency of resuscitation in critical ill patients based on hybrid simulation technology

目的采用混合模拟技术对国内3家大型三甲医院急诊医师危重症抢救能力开展评价。方法本研究纳入2018年国内3家大型三甲医院不同层级的95名急诊医师参加基于混合模拟技术的标准化情境模拟考核。采用单因素方差分析对不同类别急诊医师成绩进行比较。结果急诊医师总成绩为(62.65±18.34)分,通过率为60.0%(57/95)。培训年限满1年的急诊医师成绩为(55.07±20.86)分,满2年的为(68.53±18.13)分,满3年及以上者为(64.43±14.91)分,不同培训年限急诊医师成绩的差异具有统计学意义(P<0.05)。北京协和医院的急诊医师成绩为(61.70±14.00)分,武汉大学中南医院的为(50.11±17.06)分,同济大学附属东方医院的为(77.08±12.90)分,不同单位急诊医师的成绩差异具有统计学意义(P<0.05)。结论3家医院急诊医师危重患者抢救能力普遍存在不足,不同培训年限和来自不同单位的急诊医师在危重症患者抢救能力方面也缺乏一致性,提示亟需开展规范化培训以使急诊医师危重症抢救能力具有均质性。

Objective To evaluate the critical patients'resuscitation competency of emergency physicians based on a hybrid simulation technology carried out by three large-scale first-class hospitals in China.Methods In this study,95 emergency physicians at different levels from three large-scale and first-class hospitals in China participated in the standardized scenario simulation assessment in 2018.One way ANOVA was used to compare the scores of emergency physicians at different levels and from different hospitals.Results The total score of the 95 emergency physicians was(62.65±18.34),and the passing rate was 60.0%(57/95).The average score of emergency physicians with one year training was(55.07±20.86)and that of emergency physicians with two year training was(68.53±18.13)and those with three years training and above was(64.43±14.91).The results of comparison between groups of emergency physicians with different years of training showed statistical differences(P<0.05).The average score of emergency physicians from Peking Union Medical College Hospital was(61.70±14.00),the average score of emergency physicians from Zhongnan Hospital of Wuhan University was(50.11±17.06),and the average score of emergency physicians from Oriental Hospital Affiliated to Tongji University was(77.08±12.90).The results of emergency physicians from different hospitals showed significant difference(P<0.05).Conclusions Emergency physicians'competency for critically ill patients resuscitation is generally insufficient and the emergency physicians from different hospitals and with different training years show a heterogeneous profile,which suggests the necessity of standardized training in this field.