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Table 1 Difference points

From: The application of the spot the difference teaching method in clinical skills training for residents

Standard operation procedure

Difference points

Cardiopulmonary resuscitation

 Correct compression depth (1.5–2 inches) and fingers  off the chest

Compression depth (approximately 0.5 inches) and fingers on the chest

 Remove secretions and foreign bodies from the mouth and nose and keep the airway opening (head tilt and chin lift)

Forget to remove secretions and foreign bodies of the airway and the chin is not lifted before the artificial respiration

 Judge the resuscitation effect after five cycles

Judge the resuscitation effect after six cycles

Dressing change

 Remove the inner dressing with a tweezers

Remove the outer and inner dressing with the hand

 The second disinfection scope should be narrower than that of the first

The second disinfection scope is equal to that of the first

 A pair of tweezers contacts the incision, and the other is used to transfer the cleaning items of the dressing bowl.

Two pairs of tweezers are mixed-use

Wearing and taking off the operating gown and sterile gloves

 Extend the hands forward (not over the shoulders) during the dressing process

Extend the hands upward slightly (over the shoulders) during the dressing process

 The gloved hand shall not touch the inner surface of the other glove

The thumb of the gloved hand touches the inner surface of the other glove

 With the help of an assistant, take off the operating gown first and then the gloves

Take off the gloves first by oneself and then the operating gown with the help of an assistant

Disinfection and surgical drapes placement (neck)

 Disinfection range: Up to the lower lip, down to the nipple line, both sides to the anterior edge of the trapezius muscle

Disinfection range: Up to the submental plane, down to the clavicular pane, both sides to the anterior edge of the sternocleidomastoid

 Keep the tip of the sterilizing forceps lower than the holding end

The tip of the sterilizing forceps is occasionally over the handheld end

 Place four towels in the correct order: the lower part, opposite side, head side and trainee side

Place four towels in the wrong order: opposite side, lower part, trainee side and head side

Medical history-takinga

 Remember to ask about the predisposing factors

Forget to ask about the predisposing factors

 Ask about the negative symptoms in detail

Ignore some negative symptoms inquiry

 Good professional quality

Poor professional quality

  1. aSince the DPs of medical history-taking are not aimed at a certain disease, the DPs are for reference only as examples.