Lack of Supervision and Independent Clinical Decision Making in Postgraduate Pediatric training in Australia
Notice bibliographique
Résumé
OBJECTIVE: Evaluation of postgraduate pediatric training is a complex yet critical task. We aimed to review pediatric trainees' attitudes to clinical decision-making, levels of supervision and end of life issues in a tertiary pediatric teaching hospital in Sydney, Australia. METHOD: A questionnaire was devised and distributed to all trainees at Sydney Children's Hospital, Randwick. All responses were anonymous. Results were independently analyzed using SPSS statistical software. RESULTS: Forty percent of trainees spent three hours or less per week face to face with more senior colleagues and 14% spent greater than 10 hours per week with more senior colleagues. Seventy-five percent of trainees spent three hours or less on the phone with more senior colleagues while 10% spent five hours or more on the phone with more senior colleagues. There was no association (or correlation) (p>0.05) between seniority of trainee and the number of times a trainee met face to face or phoned a more senior colleague to discuss a management plan. One in three trainees felt that they made less than 10% of clinical decisions on their own and 54% felt that they made less than half of decisions on their own. There was a statistically significant difference between seniority of training and the percentage of important clinical decisions made (p<0.01). Nearly half the trainees (47.7%) have not had the occasion to inform families of the death or impending death of a child. There was a statistically significant difference between seniority of training and the opportunity of informing families of a death of a child (p<0.01).Greater than two thirds of trainees feel that they have not received formal training in clinical decision-making. At the completion of four years of pediatric training only half the trainees considered themselves to be making the majority of clinical decisions. CONCLUSION: There is a need for closer supervision of pediatric trainees by senior colleagues, who themselves, may require additional ongoing training to supervise appropriately. There should be a balanced environment where trainees can make safe, independent decisions. The perceived absence of clinical decision making training suggests a deficiency in the training program.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,011 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».