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Obstetric training in Emergency Medicine: a needs assessment

机译：急诊医学产科培训：需求评估

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BackgroundIdentification and management of obstetric emergencies is essential in emergency medicine (EM), but exposure to pregnant patients during EM residency training is frequently limited. To date, there is little data describing effective ways to teach residents this material. Current guidelines require completion of 2 weeks of obstetrics or 10 vaginal deliveries, but it is unclear whether this instills competency.MethodsWe created a 15-item survey evaluating resident confidence and knowledge related to obstetric emergencies. To assess confidence, we asked residents about their exposure and comfort level regarding obstetric emergencies and eight common presentations and procedures. We assessed knowledge via multiple-choice questions addressing common obstetric presentations, pelvic ultrasound image, and cardiotocography interpretation. The survey was distributed to residency programs utilizing the Council of Emergency Medicine Residency Directors (CORD) listserv.ResultsThe survey was completed by 212 residents, representing 55 of 204 (27%) programs belonging to CORD and 11.2% of 1,896 eligible residents. Fifty-six percent felt they had adequate exposure to obstetric emergencies. The overall comfort level was 2.99 (1–5 scale) and comfort levels of specific presentations and procedures ranged from 2.58 to 3.97; all increased moderately with postgraduate year (PGY) level. Mean overall percentage of items answered correctly on the multiple-choice questions was 58% with no statistical difference by PGY level. Performance on individual questions did not differ by PGY level.ConclusionsThe identification and management of obstetric emergencies is the cornerstone of EM. We found preliminary evidence of a concerning lack of resident comfort regarding obstetric conditions and knowledge deficits on core obstetrics topics. EM residents may benefit from educational interventions to increase exposure to these topics.
机译：背景技术在急诊医学（EM）中，产科紧急情况的识别和管理是必不可少的，但是在EM住院医师培训期间，孕妇怀孕的机会常常受到限制。迄今为止，几乎没有数据描述向居民传授此类材料的有效方法。目前的指南要求完成2周的产科或10例阴道分娩，但尚不清楚这是否会灌输能力。方法我们创建了15个项目，评估居民对产科急诊的信心和知识。为了评估信心，我们询问了居民关于产科急症的暴露程度和舒适度以及八种常见的表现和程序。我们通过选择常见产科表现，骨盆超声图像和心动图解释的多项选择题来评估知识。该调查已通过急诊医学住院医师理事会（CORD）名单服务分发给住院医师计划。结果该调查由212名居民完成，代表了属于CORD的204个计划中的55个（占27％），占1,896名合格居民的11.2％。 56％的人认为他们有足够的产科紧急情况暴露。总体舒适度为2.99（1-5级），特定演示和程序的舒适度为2.58至3.97。随研究生年份（PGY）的增加，这些都适度增加。在多项选择题中正确回答的项目的平均总百分比为58％，PGY水平无统计学差异。各个问题的表现在PGY水平上没有差异。结论产科急诊的识别和处理是EM的基石。我们发现初步证据表明，居民对产科病情缺乏舒适感以及核心产科知识缺乏。新兴市场居民可以从教育干预中受益，以增加对这些主题的了解。

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