Objective Clinical diagnosis is the most predominant in the criteria for determination of brain death. This paper aims to analyze the training results of clinical diagnosis for brain death determination and to improve the training program. Methods A total of 461 trainees received theoretical training, simulation skills training, bedside skills training and test analysis. The composition of trainees was analyzed and the error rates of knowledge points were calculated. Univariate and multivariate backward Logistic regression analyses were used to analyze the influence of factors including sex, age, specialty, professional qualification and hospital level, on the error rates. Results Four hundred and sixty-one trainees came from 161 hospitals. Among them, trainees of 30-49 years old occupied 77.87% (359/461), and most of them came from third grade, grade A hospitals (88.29%, 407/461). There were 200 trainees (43.39% ) from Department of Neurology, 109 trainees (23.64% ) from Department of Neurosurgery, and 88 trainees (19.09%) from Intensive Care Unit. Most of them (66.59%, 307/461) had senior certificate. Total error rate of 13 knowledge points was 5.81% (1054/18 128). The error rate of corneal reflex was the highest (24.64% , 104/422), followed by deep coma (11.59% , 365/3149), oculocephalogyric reflex (9.48%, 40/422), step and time of determination (7.48%, 138/1844), and pupillary light reflex (5.10% , 90/1766). Univariate and multivariate Logistic regression analyses showed that age (OR = 1.558, 95%CI: 1.435-1.693; P = 0.000), specialty (OR = 1.080, 95%CI: 1.021-1.143; P = 0.007) and hospital level (OR = 1.395, 95%CI: 1.174-1.659; P = 0.000) were independent risk factors associated with high error rates. Conclusions The training patterns and methods of clinical diagnosis for brain death determination should be further improved, especially the individual training, to rise the training quality.?DOI: 10.3969/j.issn.1672-6731.2015.12.006.
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机译：目的在确定脑死亡的标准中，临床诊断是最主要的。本文旨在分析临床诊断训练中确定脑死亡的训练结果，并改进训练方案。方法共有461名学员接受了理论培训，模拟技能培训，床边技能培训和测试分析。分析了学员的组成，并计算了知识点的错误率。采用单因素和多因素后向Logistic回归分析来分析性别，年龄，专业，职业资格和医院水平等因素对错误率的影响。结果来自161家医院的461名受训人员。其中，30-49岁的受训人员占77.87％（359/461），其中大多数来自三级甲等医院（88.29％，407/461）。神经外科有200名学员（43.39％），神经外科有109名学员（23.64％），重症监护室有88名学员（19.09％）。其中大多数（66.59％，307/461）具有高级证书。 13个知识点的总错误率是5.81％（1054/18 128）。角膜反射的错误率最高（24.64％，104/422），其次是深层昏迷（11.59％，365/3149），眼脑反射（9.48％，40/422），测定的步骤和时间（7.48％） （138/1844）和瞳孔光反射（5.10％，90/1766）。单因素和多因素Logistic回归分析显示年龄（OR = 1.558，95％CI：1.435-1.693; P = 0.000），专科（OR = 1.080，95％CI：1.021-1.143; P = 0.007）和医院水平（OR = 1.395，95％CI：1.174-1.659; P = 0.000）是与高错误率相关的独立危险因素。结论应进一步改善脑死亡测定的临床诊断训练模式和方法，尤其是个人训练，以提高训练质量。DOI：10.3969 / j.issn.1672-6731.2015.12.006。
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