累积总和图作为对毕业生外科住院人员能力客观评估的补充:一项探索性研究
Xiaodong Phoenix Chen1, Alan Harzman, Michael Go
1From the Department of Surgery, The Ohio State University, Columbus, OH.
Journal of the American College of Surgeons
|August 2, 2023
概括
经营时间的累积总和 (CUSUM) 图表可以提高对整体外科住院医生的能力的评估. 这一客观措施,与ACGME里程碑一起,有助于确定毕业生居民是否准备好接受实践.
科学领域:
- 医学教育 医学教育
- 进行外科手术培训.
- 能力评估能力评估能力评估能力评估能力
背景情况:
- 基于Rater的客观评估对于评估住院临床能力至关重要.
- 这项研究调查了累积总和 (CUSUM) 操作时间图表的实用性,作为评估普通外科住院医生的补充工具.
研究的目的:
- 确定CUSUM操作时间图表是否补充了医学研究生教育认证委员会 (ACGME) 里程碑评估.
- 为了帮助住院项目评估毕业的整体外科医生实践准备.
主要方法:
- 针对15名居民 (PGY4-5) 在三个程序中提取了ACGME操作和程序 (POP) 绩效和客观指标 (操作时间,病例类型,复杂性) 的里程碑评估.
- 对于每个住院者和程序,计算了CUSUM图表,将学习高原定义为至少4个情况下,在目标性能附近的偏差最小.
- 数据包括2,446例病例:胆囊切除术 (N=1234),大肠切除术 (N=507) 和 inguinal (N=705).
主要成果:
- 所有居民在他们的首席年底之前都达到了ACGME POP毕业目标.
- 对CUSUM图表的分析显示,居民之间的发展过程各不相同,只有46.7%的人在毕业后在所有三种程序中达到学习高原.
- 观察到三种CUSUM图形模式:偏斜,双模和峰和谷分布.
结论:
- 操作时间的CUSUM图表是评估外科住院医生的ACGME里程碑评估的宝贵补充.
- 整合这两种评估方法可以更全面地评估毕业生居民的实践准备.
- 这种结合的方法可以为居民过渡到独立实践的住院计划的建议提供信息.
相关概念视频
01:26Methods of Documentation IV: Focus Charting
1.1K
Focus Charting, also known as the focus charting system or "focus documentation," is a systematic documentation approach used in healthcare to organize patient information in medical records.
It typically involves three columns for recording information:
It typically involves three columns for recording information:
1.1K
01:17Flow Sheet
1.7K
Flowsheets are valuable tools in nursing documentation. They enable healthcare professionals to efficiently record and monitor various patient assessments and measurements in a consolidated format.
Here's a closer look at the examples of flowsheets commonly used by nurses:
Graphic Sheet Documentation:
Here's a closer look at the examples of flowsheets commonly used by nurses:
Graphic Sheet Documentation:
1.7K
00:58The X̄ Chart
151
The x̄ chart is a statistical tool for monitoring the means in a process.
The x̄ chart, often known as the individual control chart, is a crucial tool in statistical process control. It is designed to monitor process behavior and performance over time and is widely used in various industries to ensure that processes are operating at their optimum capacity and within specified limits.
A x̄ chart is constructed by plotting individual measurements of a quality...
The x̄ chart, often known as the individual control chart, is a crucial tool in statistical process control. It is designed to monitor process behavior and performance over time and is widely used in various industries to ensure that processes are operating at their optimum capacity and within specified limits.
A x̄ chart is constructed by plotting individual measurements of a quality...
151
01:15Nursing Evaluation
3.4K
The evaluation stage signals the end of the nursing process. The nurse gathers evaluative data to assess whether or not the patient has attained the expected results. Whereas the nurse collects data in the nursing assessment to identify the patient's health concerns, the evaluation stage data determines if the indicated health issues are resolved. Evaluative data collection includes two sections: the data acquired to evaluate patient outcomes and the time criteria for data collection.
3.4K
01:29Nursing Assessment
7.7K
The two sources for collecting information are primary and secondary. After gathering information, interpretation and validation help to complete the data. The purpose of assessment is to establish data with the initial information, to interpret data about the patient's perceived needs and health problems, and to respond to these problems identified.
The nurse collects all aspects of the patient's health in the initial assessment, establishing priorities for ongoing focused assessments...
The nurse collects all aspects of the patient's health in the initial assessment, establishing priorities for ongoing focused assessments...
7.7K
01:27Assessment of the Cardiovascular System III: Palpation
380
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
380