Kanashiro Jeanie, McAleer Sean, Roff Sue
Peter Lougheed Centre, Division of General Surgery, University of Calgary, Canada.
Surgery. 2006 Feb;139(2):150-8. doi: 10.1016/j.surg.2005.07.005.
The educational experience in the operating room is considered the centerpiece of learning for surgical residents. The educational environment is defined as the "ethos" or "climate" that affects all aspects of learning within an educational setting. A measure of the educational environment in the operating room as perceived by residents would assist educators and trainees in gauging the quality of the learning occurring within this important venue. The Operating Room Educational Environment Measure (OREEM) was adapted from an inventory validated for use with basic surgical trainees in Scotland to determine whether an inventory specifically adapted to the specialized environment of the operating room can produce a valid assessment of trainee perception of the overall educational environment and the contributing factors therein at a North American institution.
The 40-item inventory was piloted on a group of general surgery residents at the University of Calgary from November 26, 2003, to January 31, 2004.
With a response rate of 96%, the OREEM was shown to be a relevant, internally consistent (Cronbach proportional, variant = .8656) and valid tool for assessing the overall educational environment in the operating room within a Canadian surgical residency program. Four subscales included teaching and training, learning opportunities, atmosphere, and workload/supervision/support. The overall mean score of 74% suggests the learning environment may be considered satisfactory; however, areas for potential improvement are identifiable. Results reveal strengths such as a nondiscriminatory operating room atmosphere on racial and gender grounds. However, differences were shown in male and female perceptions of learning opportunities and in junior versus senior perceptions of workload, supervision, and support.
The OREEM has potential to be applied further as a quality assessment tool whose results could be used by faculty and program directors to improve the learning experiences of residents in the operating room.
手术室中的教育经历被视为外科住院医师学习的核心内容。教育环境被定义为影响教育环境中学习各个方面的“风气”或“氛围”。衡量住院医师所感知的手术室教育环境，将有助于教育工作者和学员评估在这个重要场所发生的学习质量。手术室教育环境测量工具（OREEM）改编自一个经验证可用于苏格兰基础外科实习生的量表，以确定专门针对手术室特殊环境改编的量表能否有效评估北美机构中学员对整体教育环境及其影响因素的看法。
2003年11月26日至2004年1月31日，在卡尔加里大学的一组普通外科住院医师中对这个包含40个条目的量表进行了预试验。
OREEM的回复率为96%，被证明是评估加拿大外科住院医师培训项目中手术室整体教育环境的一个相关、内部一致（克朗巴赫系数，变异系数=0.8656）且有效的工具。四个子量表包括教学与培训、学习机会、氛围以及工作量/监督/支持。总体平均分为74%，表明学习环境可能被认为是令人满意的；然而，仍可确定潜在的改进领域。结果显示了一些优势，比如手术室在种族和性别方面不存在歧视性氛围。然而，男性和女性对学习机会的看法以及初级和高级住院医师对工作量、监督和支持的看法存在差异。
OREEM有潜力进一步作为一种质量评估工具应用，其结果可供教员和项目主任用于改善住院医师在手术室的学习体验。
