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为实践做准备:巴西、西班牙和英国麻醉学住院医师能力的比较分析

Preparing for Practice: A Comparative Analysis of Anesthesiology Residency Competencies in Brazil, Spain, and the United Kingdom.

作者信息

Rodrigues Dayse Dos Santos de Almeida, Reis Rodrigues Alexia de Almeida, da Silva Ferreira Natiele Carla, Alves Luiz Anastácio

机构信息

Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.

出版信息

J Med Educ Curric Dev. 2025 Aug 8;12:23821205251358060. doi: 10.1177/23821205251358060. eCollection 2025 Jan-Dec.

Abstract

OBJECTIVES

The COVID-19 pandemic has underscored the importance of equipping medical specialists from various fields with anesthesiology skills that are essential for medical practice, such as managing acute and chronic pain, preventing substance dependence, caring for critically ill patients, and ensuring airway security. This study analyzes the presence of these anesthesiology competencies in the curricular frameworks of medical residency programs in Brazil, Spain, and the United Kingdom, all of which have universal healthcare systems, to assess how effectively these programs prepare future specialists with these crucial skills.

METHODS

We analyzed curriculum frameworks for medical residency programs and specializations in all 3 countries, focusing on anesthesiology competencies. All relevant documents, available on official government websites, were reviewed between July 1, 2023 and December 28, 2024, using Kripka's methodology.

RESULTS

Significant differences were found in competencies related to stratifying anesthetic-surgical risk ( = .027), recognizing and analyzing palliative care ( = .023), mastering the basics of conscious sedation ( = .009), multidisciplinary teamwork ( < .001), and mastering the technique of local anesthesia ( < .001). Despite these differences, the number of anesthesiology competencies was similar across all 3 countries.

CONCLUSIONS

This study identified a potential gap in resident training for crucial skills such as pain management, sedation, airway management, and hemodynamic monitoring. These are essential for high-complexity procedures. The findings suggest a need for curriculum revisions and potentially an increase in specialty program slots focused on caring for critically ill patients.

摘要

目标

新冠疫情凸显了让各领域医学专家掌握麻醉学技能的重要性,这些技能对医疗实践至关重要,如管理急慢性疼痛、预防药物依赖、护理重症患者以及确保气道安全。本研究分析了巴西、西班牙和英国(均拥有全民医疗体系)医学住院医师培训项目课程框架中这些麻醉学能力的存在情况,以评估这些项目在培养具备这些关键技能的未来专家方面的成效如何。

方法

我们分析了这三个国家医学住院医师培训项目和专业的课程框架,重点关注麻醉学能力。在2023年7月1日至2024年12月28日期间,使用克里普卡方法对官方政府网站上所有相关文件进行了审查。

结果

在与麻醉手术风险分层相关的能力(P = 0.027)、识别和分析姑息治疗(P = 0.023)、掌握清醒镇静基础知识(P = 0.009)、多学科团队合作(P < 0.001)以及掌握局部麻醉技术(P < 0.001)方面发现了显著差异。尽管存在这些差异,但三个国家的麻醉学能力数量相似。

结论

本研究发现住院医师在疼痛管理、镇静、气道管理和血流动力学监测等关键技能培训方面存在潜在差距。这些技能对于高复杂性手术至关重要。研究结果表明需要修订课程,可能还需要增加专注于护理重症患者的专科项目名额。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bede/12334835/5a49784e6208/10.1177_23821205251358060-fig1.jpg

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