医学学生在实习模拟的第一天要求的不必要的诊断成像:一项探索性研究
Julia Gärtner1, Lisa Bußenius2, Sarah Prediger1
1III. Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
BMC medical education
|October 23, 2024
概括
医学学生经常过度使用诊断成像,导致不必要的辐射暴露. 需要进行干预,以改善临床决策和减少医学教育中的认知偏见.
科学领域:
- 医学教育 医学教育
- 诊断成像 诊断成像 诊断成像
- 患者安全 患者安全
背景情况:
- 适当的测试选择对于患者的安全至关重要.
- 过度使用医学成像是一个越来越令人担忧的问题.
- 医学学生的诊断成像订购行为在很大程度上是未知的.
研究的目的:
- 探索医学生在模拟实习期间的诊断成像订购行为.
- 评估医学学生对诊断测试请求的适当性.
主要方法:
- 492名医学学生参与了涉及16例病例的模拟实验.
- 学生们使用电子系统,在患者病史后要求进行诊断测试.
- 分析重点是对有序图像,辐射暴露 (mSv) 和对不必要辐射的统计测试.
主要成果:
- 所有病例中都普遍存在不必要的诊断成像.
- 超声波 (90.9%),胸部X射线 (80.0%) 和腹部CT扫描 (69.2%) 显著过度使用.
- 37.5%的患者因不必要的成像要求而经历了显著的辐射过量.
结论:
- 医学学生对成像的过度使用源于患者的焦虑和缺失的临床数据,导致认知偏见.
- 干预是必要的,以提高学生的临床决策和减轻认知偏见.
- 进一步研究与成像过度使用相关的学生特定因素是有必要的.
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