To determine the level of understanding
of mechanical ventilation among internal medicine residents,
Cox and coworkers (1) administered a 19-question examination
to 259 residents at 31 residency programs. The average score on
the test was 74% correct (range, 37 to 100%). Most residents
correctly identified tension pneumothorax (86% correct) and
clinical findings suggestive of severe hypotension secondary to
auto positive end-expiratory pressure (intrinsic PEEP) (93%
correct). High rates of incorrect answers were found for the
setting of tidal volume in patients with the acute respiratory
distress syndrome (ARDS) (48% incorrect), identifying whether
a patient was ready for a weaning trial (38% incorrect), and
recognizing an indication for noninvasive ventilation (27% incorrect).
Higher scores were associated with closed-unit versus openunit
organization (76 versus 71% correct), resident perception
of greater versus lesser knowledge (79 versus 71% correct), and
graduation from a U.S. versus a foreign medical school (75 versus
69% correct). Only 46% of residents were satisfied with their
training in mechanical ventilation. The authors conclude that
residents in internal medicine programs may not be gaining
knowledge essential for providing care to patients requiring mechanical
ventilation. An editorial commentary by Dunn (2) accompanies
this article
To determine the level of understandingof mechanical ventilation among internal medicine residents,Cox and coworkers (1) administered a 19-question examinationto 259 residents at 31 residency programs. The average score onthe test was 74% correct (range, 37 to 100%). Most residentscorrectly identified tension pneumothorax (86% correct) andclinical findings suggestive of severe hypotension secondary toauto positive end-expiratory pressure (intrinsic PEEP) (93%correct). High rates of incorrect answers were found for thesetting of tidal volume in patients with the acute respiratorydistress syndrome (ARDS) (48% incorrect), identifying whethera patient was ready for a weaning trial (38% incorrect), andrecognizing an indication for noninvasive ventilation (27% incorrect).Higher scores were associated with closed-unit versus openunitorganization (76 versus 71% correct), resident perceptionof greater versus lesser knowledge (79 versus 71% correct), andgraduation from a U.S. versus a foreign medical school (75 versus69% correct). Only 46% of residents were satisfied with theirtraining in mechanical ventilation. The authors conclude thatresidents in internal medicine programs may not be gainingknowledge essential for providing care to patients requiring mechanicalventilation. An editorial commentary by Dunn (2) accompaniesthis article
การแปล กรุณารอสักครู่..
