來自不同專業背景和工作單位的高級心臟救命術學員的筆試成績表現分析

Analysis of Performance in Advanced Cardiac Life Support Written Test of Trainees from Different Professions and Working Units

背景和目的：高級心臟救命術（Advanced cardiac life support, ACLS）是大多數醫護人員必備的技能。我們分析不同工作背景的學員在ACLS訓練課程後，於每個子題的筆試成績表現。
方法：某醫學中心於兩個月內舉辦三次ACLS訓練課程，完訓時用相同的筆試考題評核學員。以獨立樣本t檢定比較醫生和護理學員的成績；以變異數分析比較三個不同工作單位群護理學員的成績。
結果：共181名學員參加這個研究。醫生和護理學員的平均總分分別為76.9±11.4和68.2±11.9（p<0.001），醫生比護理學員成績來得好的有「心臟停止」（p<0.05）、「心律不整」（p<0.001）和「急性冠心症和腦中風」（p<0.001）等子題。在護理學員中，內科重症、外科重症和非重症單位的平均總分並無顯著不同，然而在「心臟停止」和「急性冠心症和腦中風」等子題，外科重症單位得分最低（皆是p<0.05），其次是非重症單位，而內科重症單位分數最高。
結論：來自不同工作背景的學員在部分ACLS子題有不同的學習結果。或可鼓勵彈性的課程設計，以因應不同學員族群的特殊需求。

Background and Purpose: Advanced cardiac life support (ACLS) has become an obligatory skill for most health care workers. We evaluated the performance of trainees from different work backgrounds according to written test scores after ACLS training courses and analyzed their learning outcomes related to each subtopic.
Methods: All trainees participated in one of the three ACLS courses in a medical center within two months were evaluated with the same written test at the end of the courses. Independent t-tests were used to compare the performance between doctors and nurses. Analysis of variance models were used to further compare the performance of the three nurse groups from different working units.
Results: There were 181 trainees enrolled in this study. The mean scores for doctors and nurses were 76.9 ± 11.4 and 68.2 ± 11.9, respectively (p<0.001). Doctors had better understanding than nurses in the subtopics of “Cardiac Arrest and Post-Resuscitation Care” (p<0.05), “Arrhythmia” (p<0.001), and “Acute Coronary Syndrome (ACS) and Stroke” (p<0.001). For the nurse groups, total scores were not significantly different among the three groups. However, critical care surgical nurses had the lowest scores in the subtopics of “Cardiac Arrest and Post-Resuscitation Care” (p<0.05) and “ACS and Stroke” (p<0.05), followed by the non-critical care nurses. Critical care medical nurses had the highest scores among the three groups.
Conclusion: Trainees from different work backgrounds and professions had various learning outcomes in certain subtopics of the ACLS course. Flexibility in the course design may be needed for particular needs of the different participant groups.