急诊法律认知情况调查和急诊法律教学的探索实践

Investigation of Legal Cognition in Emergency Medicine and Exploration and Practice of Legal Education in Emergency Settings

目的通过一项医疗案例调查急诊医师的法律意识,并通过法律教学来探讨其在医疗纠纷和提高法律意识中的作用。方法选择2022年1—7月在天津医科大学总医院工作的低中年资医师和规培进修医师共112名,对其进行问卷调查,调查内容包括被调查者基本情况、对一起医疗案例的假想处置和态度、对法律法规的认知和反应情况,以及通过法律教学后事件态度变化。结果在本次调查中,有9名医师愿意尝试给予患者积极处置,有18名医师无法判定,其余85名医师均倾向转诊。对于该医疗案例,几乎全部医师(108名)均认为该医疗单位无过错,部分医师(16名)认为该责任医师有过错。经过法律教学后,医师的处置率显著提高(9名vs.52名),差异有统计学意义(P<0.001),建议转院者比例显著下降(85名vs.36名),差异有统计学意义(P<0.001),无法决定处理方式者比例反有上升,但差异无统计学意义(P>0.05)。显著改善相关法律法规掌握情况(10名vs.98名),差异有统计学意义(P<0.001),认为该事件中首诊医师存在显著过错显著增加(16名vs.78名),差异有统计学意义(P<0.001),对医院是否存在过错的认差异无统计学意义(P>0.05)。结论急诊医务人员法律意识薄弱,通过法律教学后可提高医务人员的法律意识并能显著改善临床处置应变能力。

Objective To investigate the legal consciousness of emergency physicians through a medical case,and to explore its role in medical disputes and improving legal consciousness through legal teaching.Methods A total of 112 low-to mid-career physicians and physicians in training and refresher training working in the General Hospital of Tianjin Medical University from January to July 2022 were selected to be surveyed with a questionnaire that included the basic information of the respondents,their hypothetical dispositions and attitudes toward a medical case,their knowledge of and reactions to laws and regulations,and changes in their attitudes toward the incident after going through legal teaching.Results In this survey,9 physicians were willing to try to give the patient a positive disposition,18 physicians were unable to make a determination,and the remaining 85 physicians favored referral.For this medical case,almost all physicians(108)believed that the medical unit was not at fault and some(16)believed that the responsible physician was at fault.After legal teaching,the rate of physicians'disposition significantly increased(9 vs.52),with a statistically significant difference(P<0.001),the proportion of those who recommended referral significantly decreased(85 vs.36),with a statistically significant difference(P<0.001),and the proportion of those who were unable to decide on the disposition conversely increased,but the difference was not statistically significant(P>0.05).Significantly improved mastery of relevant laws and regulations(10 vs.98),the difference was statistically significant(P<0.001),that the incident in the first physician there is a significant increase in significant fault(16 vs.78),the difference was statistically significant(P<0.001),the difference in the hospital's recognition of whether there is a fault was not statistically significant(P>0.05).Conclusion The legal consciousness of emergency medical staff is weak.The legal consciousness of emergency medical staff can be improved and the clinical coping ability can be improved significantly after legal teaching.