AEM Education and Training最新文献_第6页

Half a League Onward: A Medical Student's First Code 半个联盟向前：一个医科学生的第一准则

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-09-22 DOI: 10.1002/aet2.70094

Benjamin M. Stieren

引用次数: 0

The Association Between Performance on the Emergency Medical Services In-Training Exam and Passing the Emergency Medical Services Certifying Exam 急诊医疗服务培训考试成绩与通过急诊医疗服务资格考试的关系

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-08-28 DOI: 10.1002/aet2.70092

Brian M. Clemency, Susan J. Burnett, Johanna C. Innes, Michael O'Brien, Renoj Varughese, Nan Nan, Changxing Ma, Marta Plonka, Evan Shaw, Mohamud R. Daya, Marianne Gausche-Hill

Background

Prior studies have demonstrated a correlation between in-training exam performance and success on the certifying exam in various medical specialties. It is unknown if a relationship exists between performance on the Emergency Medical Services (EMS) In-Training Exam (EMSITE) and success on the EMS Certifying Exam (EMSCE); consequently, EMSITE score reports include percentile rankings to compare performance against other fellows, but do not offer a criterion score or prediction of success on the EMSCE. The goal of this study was to examine if an association exists between EMSITE score and success on the EMSCE.

Methods

This was a retrospective data review, linking data from EMSITE records and EMSCE records. Performances on the 2020 and 2021 EMSITE were compared to the 2021 EMSCE results. Fellows who took the EMSITE but did not take the EMSCE were excluded. EMSITE performance was examined based on overall score and for each of the four content areas. EMSCE results were dichotomized as “pass” or “fail.” Odds ratios were obtained using an unadjusted univariate logistic regression and reported with 95% confidence intervals.

Results

During the 2019–2020 and 2020–2021 academic years, 161 fellows took the EMSITE. This includes 132 (82.0%) who took the EMSCE in 2021. Among those who took the EMSCE, 117 (88.6%) passed. There was an association between the overall EMSITE score and passing the EMSCE (OR 1.17, 95% CI: 1.05–1.30). This association was demonstrated in the content areas of Medical Oversight of EMS (OR 1.14, 95% CI 1.05–1.23) and Quality Management and Research (OR 1.06, 95% CI 1.01–1.10). This association was not significant in the content areas of Clinical Aspects of EMS Medicine (OR 1.09, 95% CI 1.00–1.20) and Special Operations (OR 1.02, 95% CI 0.96–1.09).

Conclusion

These data demonstrate an association between performance on the EMSITE and success on the EMSCE.

背景先前的研究已经证明了培训考试成绩与各种医学专业认证考试的成功之间的相关性。目前尚不清楚急诊医疗服务（EMS）培训考试（EMSITE）的表现与EMS认证考试（EMSCE）的成功之间是否存在关系；因此，EMSITE分数报告包括百分位排名，以比较与其他研究员的表现，但不提供标准分数或预测成功的EMSCE。本研究的目的是检查EMSITE评分与EMSCE成功之间是否存在关联。方法回顾性分析EMSITE记录和EMSCE记录。将2020年和2021年EMSITE的性能与2021年EMSCE的结果进行了比较。参加了EMSITE但没有参加EMSCE的研究员被排除在外。EMSITE的表现是根据总分和四个内容领域中的每一个进行检查的。EMSCE结果分为“合格”和“不合格”。优势比采用未调整的单变量逻辑回归获得，报告的置信区间为95%。结果2019-2020学年和2020-2021学年，161名研究员参加了EMSITE。其中包括在2021年参加EMSCE考试的132人（82.0%）。参加高考的117人（88.6%）通过了考试。总体EMSITE评分与通过EMSCE之间存在关联（OR 1.17, 95% CI: 1.05-1.30）。这种关联在EMS的医疗监督（OR 1.14, 95% CI 1.05-1.23）和质量管理与研究（OR 1.06, 95% CI 1.01-1.10）的内容领域得到证实。这种关联在EMS医学临床方面（OR 1.09, 95% CI 1.00-1.20）和特殊手术（OR 1.02, 95% CI 0.96-1.09）的内容领域不显著。结论：这些数据证明了EMSITE的表现与EMSCE的成功之间存在关联。

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引用次数: 0

Sustained Impact: Long-Term Application of Diagnostic Uncertainty Communication Training. 持续影响：诊断不确定性沟通训练的长期应用。

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-08-06 eCollection Date: 2025-08-01 DOI: 10.1002/aet2.70086

Danielle M McCarthy, Jethel Hernandez, Dimitrios Papanagnou, Kenzie A Cameron, David H Salzman, Andrew W Long, Alexandra D Franiek, Kristin L Rising

Objectives: More than one-third of discharged emergency department (ED) patients leave without a clear diagnosis for their symptoms. In 2019-2020, we implemented a simulation-based mastery learning curriculum across two academic medical centers to train emergency medicine residents to discuss diagnostic uncertainty during ED discharge, guided by the Uncertainty Communication Checklist (UCC). We sought to assess if this cohort continues to apply skills learned and to obtain trainee insights into the most valuable checklist items.

Methods: A survey was emailed to all 109 participants who completed the training in 2019-2020. Questions assessed how often participants currently encountered uncertainty and used the skills learned in the curriculum. Additionally, participants rated how important it was to keep each of the 21 UCC items in future uncertainty communication training (4-point Likert scale: very important/important/low importance/not important). Means and proportions are reported.

Results: Sixty-five individuals responded (60%). Mean age was 33; and 30.8% were female. More than 90% encountered diagnostic uncertainty more than once per shift, and 74% applied skills learned in the training "often" or "all the time." Seven of the 21 UCC items received endorsement by more than 70% of respondents as "very important" to retain in future trainings. The item receiving the most endorsement as "very important" (90%) was to "Clearly state that either 'life-threatening' or 'dangerous' conditions have not been found." Items with lower rankings related to generally accepted communication best-practices (e.g., "make eye contact").

Conclusion: Four years following diagnostic uncertainty training completion, most respondents frequently employ skills learned from uncertainty communication training.

目的：超过三分之一的出院急诊科（ED）患者离开没有明确的诊断他们的症状。在2019-2020年，我们在两个学术医疗中心实施了基于模拟的掌握学习课程，以培训急诊医学住院医师在不确定性沟通清单（UCC）的指导下讨论急诊科出院时诊断的不确定性。我们试图评估这个队列是否继续应用所学的技能，并获得受训人员对最有价值的清单项目的见解。方法：通过电子邮件向2019-2020年完成培训的109名参与者发送调查问卷。问题评估了参与者目前遇到不确定性的频率，以及使用课程中学到的技能的频率。此外，参与者还评估了在未来不确定性沟通培训中保留21个UCC项目的重要性（4点李克特量表：非常重要/重要/低重要/不重要）。报告了平均值和比例。结果：65人有反应（60%）。平均年龄33岁；30.8%为女性。超过90%的人每班不止一次遇到诊断不确定性，74%的人“经常”或“一直”应用培训中学到的技能。在21个UCC项目中，有7个项目被超过70%的受访者认可为“非常重要”，需要在未来的培训中保留。被认为“非常重要”的项目中（90%）获得最多支持的是“明确声明没有发现‘危及生命’或‘危险’的情况”。排名较低的项目与普遍接受的沟通最佳实践有关（例如，“进行目光接触”）。结论：在诊断不确定性培训结束后的四年中，大多数受访者经常使用从不确定性沟通培训中学到的技能。

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引用次数: 0

A Novel Model of Patient Handover in Emergency Medicine—Addressing Hidden Tensions in Culture 急诊医学病人交接的新模式——解决文化中隐藏的紧张关系

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-07-30 DOI: 10.1002/aet2.70087

Stella H. Yiu, Marianne Yeung, Warren Cheung, Edmund Kwok, Gurraman Mann, Allison Williams, Jason R. Frank

Introduction

Clinical handover (or handoff), the transfer of patient care between providers, is essential in Emergency Medicine. Poor communication during handover can threaten patient safety. Existing literature views handover as an information transfer; little research has examined the human interaction within handover and how it affects patient safety. We sought a more nuanced understanding of handover to improve this critical aspect of Emergency Medicine care.

Methods

We used constructivist grounded theory to explore handover as a social phenomenon. We invited staff emergency physicians in an academic, tertiary care hospital to participate in semi-structured interviews, which were recorded, de-identified, and transcribed. The research team analyzed the transcripts in multiple progressively interpretive analytical stages: initial, focused, and theoretical. Cultural-Historical Activity Theory (CHAT) provided a framework for our data analysis. CHAT situates an individual's action into an activity system in which components interact, producing tensions. We sought to attain theoretical sufficiency by revising the interview guide and recruiting participants for specific insights.

Results

We interviewed sixteen (16) participants. During handover, the object was for the incoming physician (IP) to accept the handover plan from the outgoing physician (OP). We identified a rule requiring minimal handover plans that were realistic and dichotomous. The divisions of labor were tasks. During the interaction, emotional reactions such as judgment or compassion, and behavioral reactions such as pushback or acceptance could have resulted. There were unintended consequences from the handover process that impacted members' self-worth and generated threats to patient safety.

Conclusions

We built a novel and more nuanced framework of handover in the emergency department that involves multiple interactions and tensions. Using this new model, emergency departments should adjust their handover processes to enhance group dynamics and patient safety.

临床交接（或移交），病人护理的提供者之间的转移，是必不可少的急诊医学。交接过程中沟通不畅会威胁患者安全。现有文献认为交接是一种信息传递；很少有研究调查交接过程中的人际互动以及它如何影响患者安全。我们寻求对交接更细致入微的理解，以改善急诊医学护理的这一关键方面。方法运用建构主义理论对移交这一社会现象进行探讨。我们邀请了一家三级专科医院的急诊医生参加了半结构化访谈，并对访谈进行了记录、去识别和转录。研究小组在多个渐进的解释分析阶段对转录本进行了分析：初始阶段、重点阶段和理论阶段。文化历史活动理论（CHAT）为我们的数据分析提供了一个框架。CHAT将一个人的行为置于一个活动系统中，在这个系统中，各个组成部分相互作用，产生紧张感。我们试图通过修改面试指南和招募参与者来获得具体的见解，从而达到理论的充分性。结果我们采访了16名参与者。在交接过程中，目标是让即将入职的医生（IP）接受即将离职的医生（OP）的交接计划。我们确定了一个规则，要求最小的移交计划，这是现实的和二分的。劳动分工就是任务。在互动过程中，可能会产生诸如判断或同情之类的情绪反应，以及诸如排斥或接受之类的行为反应。交接过程中出现了意想不到的后果，影响了成员的自我价值，并对患者安全产生了威胁。我们在急诊科建立了一个新的、更细致的交接框架，涉及多种互动和紧张关系。利用这种新模式，急诊科应调整交接流程，以增强群体动力和患者安全。

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引用次数: 0

Helping Learners Receive Feedback in the Emergency Department 帮助学习者在急诊科获得反馈

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-07-30 DOI: 10.1002/aet2.70085

Megan Rivera, Michael Gottlieb, Katarzyna Gore, Samiya Natesan-Torres, Sreeja Natesan

Feedback is essential to professional development in emergency medicine, yet its impact hinges on the learner's ability to receive and apply it—an often-overlooked element of the feedback equation. In the high-acuity, time-pressured setting of the ED, creating conditions for meaningful feedback reception can be particularly challenging. This EM Download reframes feedback through the lens of the educational alliance and highlights key strategies to foster learner receptivity: cultivating trust, promoting active learning, recognizing appropriate timing, and nurturing a growth mindset. Using practical examples and the “Ask-Tell-Ask” model, this piece offers evidence-informed guidance for building a feedback culture that empowers learners and strengthens clinical education in the ED.

反馈对急诊医学的专业发展至关重要，但它的影响取决于学习者接受和应用反馈的能力——这是反馈方程中经常被忽视的元素。在急诊科的高灵敏度、时间紧迫的环境中，为有意义的反馈接收创造条件尤其具有挑战性。这个电子商务下载通过教育联盟的视角重新定义了反馈，并强调了培养学习者接受能力的关键策略：培养信任，促进主动学习，认识适当的时机，培养成长心态。通过实际案例和“问-说-问”模式，这篇文章为建立一种反馈文化提供了循证指导，这种文化赋予学习者权力，并加强了ED的临床教育。

引用次数: 0

One Thousand Cuts: Insights From a Qualitative Study Exploring Emergency Medicine Program Director Attrition and Career Experiences 一千个切口：从一项探索急诊医学项目主任减员和职业经历的定性研究中获得的见解

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-07-30 DOI: 10.1002/aet2.70088

Jaime Jordan, Kerry McCabe, Bo Burns, Arlene S. Chung, Laura R. Hopson

Background

Duration of tenure of emergency medicine (EM) program directors (PD) has decreased in recent decades. We sought to explore the perspectives of EM PDs on their job experiences to identify causes and strategies to promote longevity in the role.

Methods

Using a constructivist paradigm, we conducted semi-structured interviews of EM PDs who had recently (within 24 months) transitioned out of the PD role or were contemplating a transition. We used purposive sampling to seek diversity of participants with regard to gender, region of practice, and program training format. We collected data from January to August 2024. Three researchers independently performed a thematic analysis of interview transcripts. We resolved discrepancies through in-depth discussion and negotiated consensus.

Results

12 PDs participated. Our analysis revealed that PDs came into their roles with idealism and a desire to meaningfully impact their trainees, programs, and patients. They experienced fulfillment from having an impact on their trainees and the field of EM, performing an intellectually challenging job, solving problems, and leading their teams to success. They struggled with the high administrative burden, lack of support and resources, challenging interpersonal interactions, and a substantial burden of responsibility oftentimes coupled with limited power to enact change. The misalignment between their ideals and goals and the realities of their job contributed to emotional exhaustion, burnout, and a desire to leave the role. Participants had recommendations at the individual, institutional, and organizational levels to support PDs in their careers.

Conclusion

This study illuminates the positive and negative experiences of PDs in their roles and provides insight into how PD longevity can be supported.

背景：近几十年来，急诊医学（EM）项目主任（PD）的任期有所减少。我们试图探索EM博士对其工作经历的看法，以确定促进角色长寿的原因和策略。方法采用建构主义范式，我们对最近（在24个月内）从PD角色过渡或正在考虑过渡的EM PD进行了半结构化访谈。我们使用有目的的抽样来寻求参与者在性别、实践地区和项目培训形式方面的多样性。我们收集了2024年1月至8月的数据。三位研究者分别对访谈记录进行了专题分析。我们通过深入讨论、协商一致解决分歧。结果12名pd参与。我们的分析显示，pd是带着理想主义和有意义地影响他们的学员、项目和患者的愿望进入他们的角色的。他们从对学员和EM领域的影响、执行具有智力挑战的工作、解决问题和领导团队走向成功中获得满足感。他们与繁重的行政负担、缺乏支持和资源、具有挑战性的人际交往以及往往伴随着有限的权力来实施变革的重大责任负担作斗争。他们的理想和目标与工作现实之间的不一致导致了情感上的疲惫、倦怠和离开这个角色的愿望。与会者在个人、机构和组织层面提出了建议，以支持pd的职业生涯。结论本研究阐明了PD在其角色中的积极和消极经历，并为如何支持PD长寿提供了见解。

{"title":"One Thousand Cuts: Insights From a Qualitative Study Exploring Emergency Medicine Program Director Attrition and Career Experiences","authors":"Jaime Jordan, Kerry McCabe, Bo Burns, Arlene S. Chung, Laura R. Hopson","doi":"10.1002/aet2.70088","DOIUrl":"https://doi.org/10.1002/aet2.70088","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Duration of tenure of emergency medicine (EM) program directors (PD) has decreased in recent decades. We sought to explore the perspectives of EM PDs on their job experiences to identify causes and strategies to promote longevity in the role.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a constructivist paradigm, we conducted semi-structured interviews of EM PDs who had recently (within 24 months) transitioned out of the PD role or were contemplating a transition. We used purposive sampling to seek diversity of participants with regard to gender, region of practice, and program training format. We collected data from January to August 2024. Three researchers independently performed a thematic analysis of interview transcripts. We resolved discrepancies through in-depth discussion and negotiated consensus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>12 PDs participated. Our analysis revealed that PDs came into their roles with idealism and a desire to meaningfully impact their trainees, programs, and patients. They experienced fulfillment from having an impact on their trainees and the field of EM, performing an intellectually challenging job, solving problems, and leading their teams to success. They struggled with the high administrative burden, lack of support and resources, challenging interpersonal interactions, and a substantial burden of responsibility oftentimes coupled with limited power to enact change. The misalignment between their ideals and goals and the realities of their job contributed to emotional exhaustion, burnout, and a desire to leave the role. Participants had recommendations at the individual, institutional, and organizational levels to support PDs in their careers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study illuminates the positive and negative experiences of PDs in their roles and provides insight into how PD longevity can be supported.</p>\u0000 </section>\u0000 </div>","PeriodicalId":37032,"journal":{"name":"AEM Education and Training","volume":"9 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How to Be Coachable 如何被指导

IF 1.8 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-07-30 DOI: 10.1002/aet2.70090

Jeremy Branzetti, Richard C. Winters

引用次数: 0

Enhancing Emergency Medicine Resident Transitions: The Impact of Structured Orientation Programs on Comfort and Preparedness 加强急诊医学住院医师的过渡：结构导向计划对舒适和准备的影响

IF 1.7 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-07-23 DOI: 10.1002/aet2.70080

Jessica Baez, Erin McDonough

Background

Emergency medicine (EM) training programs vary in how residents are exposed to clinical responsibilities. Transitioning to new roles often causes stress and uncertainty. Structured orientation programs may alleviate these challenges.

Methods

We implemented three role-specific orientation sessions targeting post-graduate year (PGY)-2, PGY-3, and PGY-4 EM residents at a 4-year residency program. Pre- and post-surveys measured comfort with clinical, supervisory, and system-based skills. Paired t-tests assessed changes.

Results

All three orientation sessions significantly improved self-reported comfort across various domains. Participating PGY-2 residents (n = 10) showed increased preparedness for managing critical conditions. PGY-3 residents (n = 6) demonstrated improved confidence in procedural supervision and knowledge of rare procedures. PGY-4 residents (n = 11) transitioning to attending roles showed the largest gains, particularly in billing and medico-legal domains.

Conclusion

Structured orientation improves EM resident readiness for role transitions. These findings support the integration of targeted educational interventions to enhance performance and preparedness.

背景急诊医学（EM）培训项目因住院医师如何承担临床责任而有所不同。向新角色的过渡经常会带来压力和不确定性。结构化的培训项目可能会缓解这些挑战。方法：我们针对一个为期4年的住院医师项目的研究生二年级、研究生三年级和研究生四年级的EM住院医师实施了三次角色定位培训。前后调查测量舒适度与临床，监督和系统为基础的技能。配对t检验评估变化。结果三次培训均显著提高了各领域的自我报告舒适度。参与PGY-2的居民（n = 10）在处理危急情况方面表现出更强的准备。PGY-3住院医师（n = 6）表现出对程序监督和罕见程序知识的信心提高。转为主治医师的PGY-4住院医师（n = 11）的收益最大，特别是在计费和医疗法律领域。结论：结构化取向提高了EM住院医师角色转换的准备程度。这些发现支持有针对性的教育干预措施的整合，以提高绩效和准备。

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引用次数: 0

Metamorphosis 蜕变

IF 1.7 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-07-23 DOI: 10.1002/aet2.70078

Zhaohui Su

引用次数: 0

Simulation Platforms to Train and Assess Pediatric Acute Care Procedural Skills: A Scoping Review 模拟平台训练和评估儿科急症护理程序技能：范围审查

IF 1.7 Q2 EDUCATION, SCIENTIFIC DISCIPLINES

AEM Education and Training

Pub Date : 2025-07-23 DOI: 10.1002/aet2.70083

Shayan Novin, Tehrim Younas, Jessie Xu, Samuel Graef, Nima Karimi, Maggie Xu, Jo-Anne Petropoulos, Quang Ngo, Elif Bilgic

Background

Medical trainees have limited opportunities to practice certain pediatric emergency medicine (PEM) procedures in the clinical setting. Simulation-based education provides an opportunity for trainees to improve their technical and non-technical skills. This scoping review aimed to explore the ways in which simulation has been used to train and assess medical learners.

Methods

A search was conducted from 2011 to August 2022 using MEDLINE, OVID Embase, OVID Emcare, and Cochrane Trials, among others. The review included empirical studies that used simulation for training medical trainees in four essential pediatric procedures: intubation, lumbar puncture, intraosseous insertion, and chest tube insertion. Six reviewers independently screened titles, abstracts, and full texts. Data were recorded, stored, and summarized in a standardized spreadsheet.

Results

The search retrieved 4073 articles, of which 207 underwent full-text screening. Data were extracted from 107 studies. Among these, 69 studies focused exclusively on intubation skills, 19 studies on lumbar puncture, 10 studies on intraosseous insertion, and two studies on chest tube insertion. The majority of studies (n = 61) involved residents, while 15 studies focused on medical students. Training platforms included mannequins (n = 84), ex-vivo models (n = 6), task trainers (n = 4), and standardized patients (n = 1). Competency was largely assessed using an assessment tool (n = 45) as the sole assessment method.

Conclusions

Simulation-based training and assessment can support medical learners in developing key technical and non-technical skills related to PEM procedures. However, there is a need for diversification of simulation platforms used, expansion of procedures targeted in simulation-based training and assessment programs, and creation of standardized and procedure-specific assessments.

医学培训生在临床环境中实践某些儿科急诊医学（PEM）程序的机会有限。基于模拟的教育为受训者提供了提高技术和非技术技能的机会。这一范围审查旨在探讨的方式，其中模拟已被用于培训和评估医学学习者。方法检索自2011年至2022年8月的MEDLINE、OVID Embase、OVID Emcare和Cochrane Trials等。这篇综述包括了一些实证研究，这些研究使用模拟技术对医学实习生进行四项基本儿科手术的培训：插管、腰椎穿刺、骨内插入和胸管插入。六名审稿人独立筛选标题、摘要和全文。数据被记录、存储并汇总在一个标准化的电子表格中。结果共检索到4073篇文章，其中207篇进行了全文筛选。数据来自107项研究。其中专门研究插管技巧的研究69项，腰椎穿刺19项，骨内插入10项，胸管插入2项。大多数研究（n = 61）涉及住院医生，而15项研究关注医科学生。训练平台包括人体模型（n = 84）、离体模型（n = 6）、任务训练器（n = 4）和标准化患者（n = 1）。能力评估主要使用评估工具（n = 45）作为唯一的评估方法。结论基于模拟的培训和评估可以帮助医学学习者发展与PEM程序相关的关键技术和非技术技能。然而，需要使用多样化的模拟平台，扩展基于模拟的培训和评估计划的程序，并创建标准化和特定程序的评估。

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引用次数: 0