Variations in Trauma Education Practices Across Emergency Medicine Residencies: Insights from a National Survey of Program Directors.

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Advances in Medical Education and Practice Pub Date : 2024-11-02 eCollection Date: 2024-01-01 DOI:10.2147/AMEP.S475489
Stephanie Stroever, Colten Lanning, Miloš Buhavac, Cameran Mecham, Andrea Weitz, Frank Frankovsky, Andres Rios, James Morris
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Abstract

Purpose: Care of the acutely injured trauma patient is integral to the practice of emergency medicine. It is currently unknown how most emergency medicine residencies structure their residents' trauma experience and little guidance for competency assessment is provided by the Residency Review Committee. Our study aimed to determine current emergency medicine residency practices in trauma resuscitation.

Patients and methods: We conducted a cross-sectional survey of members of the Council of Residency Directors in Emergency Medicine (CORD) listserv in April 2023. Frequency with percentage of item responses is reported and differences across trauma levels assessed via Fisher's exact test (α = 0.05).

Results: Fifty-seven program directors responded to the survey (21.9%), the majority of whom operate at Level I facilities. Significantly more Level II/ III centers send residents to other sites for trauma experience compared to Level I (p = 0.000). Residents participate in all key procedures (eg, airway management, central venous access) when managing traumas except thoracotomy where participation was notably lower and statistically different across levels (p = 0.000). Lastly, program directors were very confident their residents can lead traumas independently and few acknowledged citations for deficiency in trauma training.

Conclusion: Trauma training and confirmation of competency is critical among EM residents who may serve as the sole lead in rural emergency departments. This study demonstrates that there is considerable variability in how residency programs structure trauma education, particularly with regards to the exposure to invasive procedures and the opportunity to lead trauma resuscitations. As the American Board of Emergency Medicine has introduced requirements for program directors to attest specifically to the competence of residents to lead trauma resuscitations, standardized and validated tools should be adopted to support this attestation and ensure competence regardless of the program hospital's trauma level.

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急诊医学住院医生在创伤教育实践中的差异:来自全国项目主任调查的启示。
目的:对急性创伤患者的护理是急诊医学实践中不可或缺的一部分。目前尚不清楚大多数急诊医学住院医师如何安排其住院医师的创伤经验,住院医师审查委员会也很少提供能力评估指导。我们的研究旨在确定目前急诊医学住院医师在创伤复苏方面的做法:我们于 2023 年 4 月对急诊医学住院医师指导委员会 (CORD) 列表服务器的成员进行了横断面调查。报告了项目回复的频率和百分比,并通过费雪精确检验(α = 0.05)评估了不同创伤级别之间的差异:结果:57 名项目主任(21.9%)对调查做出了回复,其中大部分人在一级医疗机构工作。与一级医疗机构相比,二级/三级医疗机构派遣住院医师到其他医疗机构进行创伤体验的人数明显增多(p = 0.000)。住院医师在处理创伤时参与了所有关键程序(如气道管理、中心静脉通路),但胸廓切开术除外,该手术的参与度明显较低,且不同级别的参与度存在统计学差异(P = 0.000)。最后,项目主任对他们的住院医师能够独立处理创伤非常有信心,很少有住院医师承认在创伤培训中存在不足:结论:创伤培训和能力确认对于可能成为农村急诊科唯一负责人的急诊科住院医师来说至关重要。这项研究表明,住院医师培训项目在如何组织创伤教育方面存在很大差异,尤其是在接触侵入性程序和领导创伤复苏的机会方面。由于美国急诊医学委员会已要求项目主任证明住院医师有能力领导创伤复苏,因此,无论项目医院的创伤级别如何,都应采用标准化和经过验证的工具来支持这种证明,并确保住院医师有能力领导创伤复苏。
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来源期刊
Advances in Medical Education and Practice
Advances in Medical Education and Practice EDUCATION, SCIENTIFIC DISCIPLINES-
CiteScore
3.10
自引率
10.00%
发文量
189
审稿时长
16 weeks
期刊最新文献
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