Moorthy Krishna, Munz Yaron, Adams Sally, Pandey Vikas, Darzi Ara
Department of Surgical Oncology and Technology, Imperial College, St. Mary's Hospital, 28 Carless Ave., Birmingham, London B17 9EQ, UK.
Am J Surg. 2006 Jul;192(1):114-8. doi: 10.1016/j.amjsurg.2005.09.017.
The ability of surgeons to assess their own performance is essential for training and self-regulation. The latter is based on the premise that they recognize their weaknesses and seek remedial action accordingly.
Twenty-seven surgical trainees performed a simulated saphenofemoral high-tie on a synthetic model in a simulated operating theater. The performance assessment consisted of blinded rating of technical skills and a global rating of team skills by a human factors expert and a trained surgical research fellow. Subjects also were asked to assess their own performance using the same methods. Spearman's rho was used for data analysis.
There was a strong correlation between the experts rating of technical skills and self-assessment (rho = .64). However, the correlation improved with increasing experience. It was .24 for junior trainees, .43 for those with intermediate experience, and .52 for senior trainees. There was a low correlation between the self-assessment and the expert scores for human factors skills (rho = .31). The correlation was higher for the 2 junior groups compared with the senior trainees.
Unlike other studies on self-assessment, this study found that senior surgical trainees are accurate in their self-assessment of technical skills. However, this was not true in the case of human factors skills.
外科医生评估自身表现的能力对于培训和自我规范至关重要。自我规范基于这样一个前提,即他们认识到自己的弱点并据此寻求补救措施。
27名外科实习生在模拟手术室中对一个合成模型进行了模拟大隐静脉股静脉高位结扎术。绩效评估包括由一名人为因素专家和一名经过培训的外科研究员对技术技能进行盲评以及对团队技能进行整体评分。受试者还被要求使用相同的方法评估自己的表现。采用斯皮尔曼等级相关系数进行数据分析。
专家对技术技能的评分与自我评估之间存在很强的相关性(rho = 0.64)。然而,这种相关性随着经验的增加而提高。初级实习生的相关性为0.24,中级经验者为0.43,高级实习生为0.52。自我评估与专家对人为因素技能的评分之间的相关性较低(rho = 0.31)。与高级实习生相比,两个初级组的相关性更高。
与其他关于自我评估的研究不同,本研究发现高级外科实习生对技术技能的自我评估是准确的。然而,在人为因素技能方面并非如此。