使用自然语言处理量化紧急医疗住院学习曲线:回顾性队列研究
Carl Preiksaitis1, Joshua Hughes1, Rana Kabeer1
1Department of Emergency Medicine, Stanford University School of Medicine, 900 Welch Road, Suite 350, Palo Alto, CA, 94304, United States, 1 650-723-6576, 1 650-723-0121.
JMIR medical education
|December 9, 2025
概括
临床文档的自然语言处理 (NLP) 显示,紧急医疗 (EM) 住院人员在整个培训过程中获得了显著的新临床主题接触,甚至到他们的第四年. 这支持一个为期四年的EM居住模式,以提高教育价值.
科学领域:
- 医学教育 医学教育
- 紧急医疗 紧急医疗
- 计算语言学 计算语言学
背景情况:
- 正在讨论紧急医疗 (EM) 住院培训的最佳持续时间,并可能将其标准化为4年.
- 关于住院临床暴露积累和诊断推理深度的经验数据有限.
- 自然语言处理 (NLP) 为全面的临床经验量化提供了一种新的方法.
研究的目的:
- 量化EM住院患者随着时间的推移获得的临床主题暴露量.
- 评估居民和毕业生之间的暴露模式的变化.
- 评估工作量和案例复杂性的变化,以告知最佳程序长度.
主要方法:
- 62名EM居民和244,255次ED遭遇 (2016-2023) 的回顾性队列研究.
- 利用提取增强代NLP管道将临床文档映射到2022年紧急医疗临床实践模型 (MCPEM) 的子类别.
- 分析了累计的主题暴露,覆盖范围的多样性,居民间的变化,临床复杂性 (ESI分数) 和入院率.
主要成果:
- 居民在PGY1中获得了最多的新话题,暴露时间停滞在39-41个月左右,但个体差异很大.
- 根据PGY4,居民平均占MCPEM子类别的63.2%,比PGY3.3增加9.9%.
- 每年的病例数量从PGY1增加了三倍以上,到PGY4,病例复杂性增加 (ESI得分较低,ESI1-2病例较高).
结论:
- NLP提供了一个可扩展的,详细的方法来跟踪EM居民的临床暴露和进展.
- 住院人员继续获得新的经验,包括更高急性病例,进入第四年.
- 4年培训模式可能提供额外的教育价值,强调由于学习轨迹的变化,需要个性化评估.
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