背景:体格检查似乎是远程会诊(TC)的限制因素。与面对面咨询(FC)相比,我们评估了腰椎窝(sPLF)和TC对单纯性肾绞痛(SRC)的自我撞击的可行性。
方法:我们分两步进行了一项比较前瞻性研究。首先:对TC标准化患者的sPLF质量进行评估,没有和与教程。其次:在真实条件下使用标准化患者评估SRC的TC和FC。由观察者使用客观临床评分和定性量表进行评估,标准化患者和从业者本人。
结果:42名从业者被纳入研究。在没有教程的情况下,sPLF通常是“做得不好”。该教程导致sPLF质量的显着改善。TC和FC之间的高级医师的诊断和治疗性能没有差异。在他不知情的情况下,实习生的TC治疗表现明显较低。根据从业者的数据,TC与FC的定性得分明显较低,标准化患者和观察者。
结论:sPLF是可行的,但应该教授它的实践。不像实习生,高级医师能够执行与FC相当的TC来管理SRC。因此,TC和远程医学需要专门的培训和经验丰富的从业者。
方法:
BACKGROUND: Physical examination appears to be a limiting factor of teleconsultation (TC). We evaluated the feasibility of self-percussion of the lumbar fossae (sPLF) and TC for simple renal colic (SRC) in comparison with a face-to-face consultation (FC).
METHODS: We performed a comparative prospective
study in two steps. First: evaluation of the quality of an sPLF on a standardized patient in TC, without and with tutorial. Secondarily: evaluation of a TC and a FC for a SRC with a standardized patient in real conditions. Evaluation using objective clinical scores and qualitative scales by an observer, the standardized patient and the practitioner himself.
RESULTS: Forty-two practitioners were included in the
study. In the absence of a tutorial, the sPLF was most often \"poorly done\". The tutorial led to a significant improvement in the quality of sPLF. There was no difference in diagnostic and therapeutic performance among senior physicians between TC and FC. The therapeutic performances of the interns were significantly lower in TC without his being aware of it. The qualitative scores were significantly lower in TC vs FC according to the practitioners, the standardized patient and the observer.
CONCLUSIONS: An sPLF is feasible but its practice should be taught. Unlike interns, senior physicians were able to perform a TC comparable to FC for the management of SRC. TC and telesemiology therefore require dedicated training and an experienced practitioner.
METHODS: