Kirton O C, Antonetti M, Morejon O, Dobkin E, Angelica M D, Reilly P J, Serebriakov I, Horowitz S, Civetta J M
Department of Surgery, University of Connecticut Health Center, School of Medicine, Farmington, CT 06120-5037, USA.
Surgery. 2001 Aug;130(2):289-95. doi: 10.1067/msy.2001.116031.
We used a Web-based evaluation system to institute specific changes to various clinical teaching services in our integrated residency in an effort to optimize the overall quality of the educational experience and measured the resident satisfaction in these rotations.
Residents rated 8 categories of experience on a scale of 1 to 5 (maximum summation score, 40 points). Data were analyzed by t-test for equality of means. A probability value of less than.05 was considered significant.
Compliance with completion of the evaluations was 100%. The Chronbach's alpha reliability coefficient of the tool was 0.826. Tukey's estimate of power to achieve additivity was 1.5. Six under-performing services were re-engineered with prominent effects on 7 postgraduate year (PGY) rotations. On 2 general surgery services at 1 hospital, the workload was redistributed, and a dedicated team teaching time was instituted (PGY-3 [a]: before, 22 points/after, 31 points; P =.003; PGY-3 [b]: before, 25 points/after, 31 points; P =.004; PGY-1: before, 24 points/after, 29 points; P =.07). A general surgery service at another hospital redistributed coverage of the attending surgeons to create a nonteaching service (PGY-1: before, 22 points/-after, 27 points; P =.01). The transplantation service (PGY-3) was examined, and the role of the point was redefined (before, 24 points/after, 31 points; P =.01). One vascular service (PGY-2) redistributed cases and workload (before, 27 points/after, 22 points; P =.07). The vascular PGY-2 position was eliminated and replaced by a mid-level practitioner. The cardiothoracic service (PGY-1) rotation was converted into a preceptorship (before, 23 points/after, 30 points; P =.015).
A web-based clinical rotation evaluation provides a means for the assessment of the impact of programmatic changes while preserving resident anonymity and maintaining accountability.
我们使用了一个基于网络的评估系统，对我们综合住院医师培训项目中的各种临床教学服务进行特定的改进，以优化教育体验的整体质量，并衡量住院医师对这些轮转的满意度。
住院医师对8类体验进行评分，评分范围为1至5分（最高总分40分）。采用t检验分析均值是否相等。概率值小于0.05被认为具有统计学意义。
评估完成率为100%。该工具的克朗巴赫α信度系数为0.826。实现可加性的图基功效估计值为1.5。对六项表现不佳的服务进行了重新设计，对7个研究生年级（PGY）的轮转产生了显著影响。在一家医院的2个普通外科服务中，重新分配了工作量，并设定了专门的团队教学时间（PGY-3 [a]：之前，22分/之后，31分；P = 0.003；PGY-3 [b]：之前，25分/之后，31分；P = 0.004；PGY-1：之前，24分/之后，29分；P = 0.07）。另一家医院的一个普通外科服务重新分配了主治医生的覆盖范围，以创建一个非教学服务（PGY-1：之前，22分/之后，27分；P = 0.01）。对移植服务（PGY-3）进行了检查，并重新定义了重点（之前，24分/之后，31分；P = 0.01）。一个血管外科服务（PGY-2）重新分配了病例和工作量（之前，27分/之后，22分；P = 0.07）。取消了血管外科PGY-2的职位，由一名中级从业者取代。心胸外科服务（PGY-1）的轮转转变为带教制（之前，23分/之后，30分；P = 0.015）。
基于网络的临床轮转评估提供了一种评估项目变化影响的方法，同时保护住院医师的匿名性并保持问责制。
