• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of postmedjPostgraduate Medical JournalVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Postgrad Med J. Jun 2002; 78(920): 335–338.
PMCID: PMC1742405

Knowledge of aspects of acute care in trainee doctors

Abstract

Deficiencies in trainees' knowledge, skills, and attitudes have the potential to influence the initial assessment, treatment, and outcome of acutely ill ward patients. Knowledge of basic aspects of acute care were assessed among a group of 185 trainee doctors at six hospitals. Many were unaware of the signs of total airway obstruction, confusing them with those of partial obstruction (pre-registration house officers (PRHOs) 11%, senior house officers (SHOs) 14%) or apnoea (PRHOs 47%, SHOs 26%). Knowledge about the use of non-rebreathing oxygen masks was poor; 23% of trainees could not describe the purpose of the reservoir bag or gave answers that were unclear or incorrect. Seven trainees thought that it was involved in humidification, or carbon dioxide collection or removal. Seventeen per cent of trainees could not quote the maximum deliverable inspired oxygen concentration provided by these masks or gave values below the normal range. Thirty one per cent of trainees thought that the lower end of the normal range for pulse oximetry (SpO2) was below 95%; nine (5%) believed it to be below 90%. There was also poor knowledge of the factors influencing the function of a pulse oximeter. Similar deficits in knowledge and understanding existed in relation to the normal capillary refill time, minimum hourly urine output, the use of the AVPU scale and the role of blood glucose testing in unconscious adults. Only 22% of PRHOs and 21% of SHOs identified the correct percentage hospital survival for patients who suffer an in-hospital cardiac arrest. Knowledge of aspects of consent was unsatisfactory. It is recommended that all medical schools urgently incorporate training about common aspects of "generic" acute care in their curricula.

Full Text

The Full Text of this article is available as a PDF (89K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Rolfe S, Harper NJ. Ability of hospital doctors to calculate drug doses. BMJ. 1995 May 6;310(6988):1173–1174. [PMC free article] [PubMed]
  • Montgomery H, Hunter S, Morris S, Naunton-Morgan R, Marshall RM. Interpretation of electrocardiograms by doctors. BMJ. 1994 Dec 10;309(6968):1551–1552. [PMC free article] [PubMed]
  • David J, Prior-Willeard PF. Resuscitation skills of MRCP candidates. BMJ. 1993 Jun 12;306(6892):1578–1579. [PMC free article] [PubMed]
  • Yentis SM. Use of intravenous cannulae by junior hospital doctors. Postgrad Med J. 1993 May;69(811):389–391. [PMC free article] [PubMed]
  • Gould TH, Upton PM, Collins P. A survey of the intended management of acute postoperative pain by newly qualified doctors in the south west region of England in August 1992. Anaesthesia. 1994 Sep;49(9):807–810. [PubMed]
  • Teahon K, Bateman DN. A survey of intravenous drug administration by preregistration house officers. BMJ. 1993 Sep 4;307(6904):605–606. [PMC free article] [PubMed]
  • Vincent C, Neale G, Woloshynowych M. Adverse events in British hospitals: preliminary retrospective record review. BMJ. 2001 Mar 3;322(7285):517–519. [PMC free article] [PubMed]
  • Schein RM, Hazday N, Pena M, Ruben BH, Sprung CL. Clinical antecedents to in-hospital cardiopulmonary arrest. Chest. 1990 Dec;98(6):1388–1392. [PubMed]
  • Franklin C, Mathew J. Developing strategies to prevent inhospital cardiac arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med. 1994 Feb;22(2):244–247. [PubMed]
  • McQuillan P, Pilkington S, Allan A, Taylor B, Short A, Morgan G, Nielsen M, Barrett D, Smith G, Collins CH. Confidential inquiry into quality of care before admission to intensive care. BMJ. 1998 Jun 20;316(7148):1853–1858. [PMC free article] [PubMed]
  • McGloin H, Adam SK, Singer M. Unexpected deaths and referrals to intensive care of patients on general wards. Are some cases potentially avoidable? J R Coll Physicians Lond. 1999 May-Jun;33(3):255–259. [PubMed]
  • Neale G. Risk management in the care of medical emergencies after referral to hospital. J R Coll Physicians Lond. 1998 Mar-Apr;32(2):125–129. [PubMed]
  • Buist MD, Jarmolowski E, Burton PR, Bernard SA, Waxman BP, Anderson J. Recognising clinical instability in hospital patients before cardiac arrest or unplanned admission to intensive care. A pilot study in a tertiary-care hospital. Med J Aust. 1999 Jul 5;171(1):22–25. [PubMed]
  • Jones A, McArdle PJ, O'Neill PA. How well prepared are graduates for the role of pre-registration house officer? A comparison of the perceptions of new graduates and educational supervisors. Med Educ. 2001 Jun;35(6):578–584. [PubMed]
  • Schriger DL, Baraff L. Defining normal capillary refill: variation with age, sex, and temperature. Ann Emerg Med. 1988 Sep;17(9):932–935. [PubMed]
  • Kruger PS, Longden PJ. A study of a hospital staff's knowledge of pulse oximetry. Anaesth Intensive Care. 1997 Feb;25(1):38–41. [PubMed]
  • Rodriguez LR, Kotin N, Lowenthal D, Kattan M. A study of pediatric house staff's knowledge of pulse oximetry. Pediatrics. 1994 May;93(5):810–813. [PubMed]
  • Stoneham MD, Saville GM, Wilson IH. Knowledge about pulse oximetry among medical and nursing staff. Lancet. 1994 Nov 12;344(8933):1339–1342. [PubMed]
  • Goodfellow PB, Claydon P. Students sitting medical finals--ready to be house officers? J R Soc Med. 2001 Oct;94(10):516–520. [PMC free article] [PubMed]
  • McManus IC, Richards P, Winder BC, Sproston KA, Vincent CA. The changing clinical experience of British medical students. Lancet. 1993 Apr 10;341(8850):941–944. [PubMed]
  • Remmen R, Derese A, Scherpbier A, Denekens J, Hermann I, van der Vleuten C, Van Royen P, Bossaert L. Can medical schools rely on clerkships to train students in basic clinical skills? Med Educ. 1999 Aug;33(8):600–605. [PubMed]
  • Ringsted Charlotte, Schroeder Torben V, Henriksen Jørgen, Ramsing Benedicte, Lyngdorf Peter, Jønsson Viggo, Scherpbier Albert. Medical students' experience in practical skills is far from stakeholders' expectations. Med Teach. 2001 Jul;23(4):412–416. [PubMed]
  • McManus IC, Richards P, Winder BC. Clinical experience of UK medical students. Lancet. 1998 Mar 14;351(9105):802–803. [PubMed]
  • Phillips PS, Nolan JP. Training in basic and advanced life support in UK medical schools: questionnaire survey. BMJ. 2001 Jul 7;323(7303):22–23. [PMC free article] [PubMed]
  • Smith Gary B, Osgood Vicky M, Crane Sue. ALERT--a multiprofessional training course in the care of the acutely ill adult patient. Resuscitation. 2002 Mar;52(3):281–286. [PubMed]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...