Protocol-directed care in the ICU making a future generation of intensivists less knowledgeable 英文参考文献.docVIP

Diringer and Yende Critical Care 2012,16:307 /content/16/2/307 JOURNAL CLU B CRITIQUE Protocol-Directed Care in the ICU: Making a Future Generation of Intensivists Less Knowledgeable? Erik Diringer and Sachin Yende* 1 1,2 University of Pittsburgh Department of Critical Care Medicine: Evidence-Based Medicine Journal Club, edited by Sachin Yende Expanded abstract Citation adjusted analyses were birth country, residency training country, and overall ? rst-attempt score on the ABIM Internal Medicine Certi? cation Examination. Prasad M, Holmboe ES, Lipner RS, Hess BJ, Christie JD, Bellamy SL, Rubenfeld GD, Kahn JM. Clinical Protocols and Trainee Knowledge About Mechanical Ventilation. JAMA. 2011; 306(9):935-941. PubMed PMID:is is available on Results e 90 of 129 programs (70%) responded to the survey. Seventy seven programs (86%) had protocols for venti- lation liberation, 66 (73%) for sedation management, and 54 (60%) for lung-protective ventilation at the time of the survey. Eighty eight (98%) of these programs had trainees Background Clinical protocols are associated with improved patient out comes; however, they may negatively a? ect medical who completed the ABIM Critical Care Medicine edu ca tion by removing trainees from clinical decision Certi? cation Examination, totaling 553 examinees. Of making. these 88 programs, 27 (31%) had 0 protocols, 19 (22%) had 1 protocol, 24 (27%) had 2 protocols, and 18 (20%) had 3 protocols for at least 3 years. 42 programs (48%) Methods Objective: To study the relationship between critical care were classi? ed as high intensity and 46 (52%) as low training with mechanical ventilation protocols and subsequent knowledge about ventilator management. Design: A retrospective cohort equivalence study linking intensity, with 304 trainees (55%) a