Bernstein Mark, Hamstra Stanley J, Woodrow Sarah, Goldsman Shaila, Reznick Richard K, Fairholm David
Department of Surgery, University of Toronto, Toronto, Canada M5G 1L5.
Surg Neurol. 2006 Aug;66(2):117-24; discussion 124-6. doi: 10.1016/j.surneu.2005.12.033.
There are challenges facing surgical education in both the developing and the developed worlds. Few studies have examined trainee perceptions of their educational needs in a systematic way. We undertook a study to examine this issue, focusing on two large training programs, one in the developed world and one in the developing world.
Neurosurgical trainees at the University of Toronto, Toronto, Canada, and at Hasan Sadikin Hospital in Bandung, Indonesia, were surveyed with a comprehensive questionnaire assessing both the content and the methods of their training. The questionnaire had 37 quantitative questions requesting responses on a 7-point Likert scale and three open-ended questions to give more qualitative data.
Sixty-four percent of all trainees responded. A number of interesting findings about the strengths and weaknesses of training emerged. For example, Bandung trainees felt they had excellent training in trauma but not in specialty areas, especially spine and vascular, with ample opportunity to operate as the primary surgeon. Toronto trainees felt that the volume and the variety of cases were excellent but they did not have enough ambulatory experience, and that they had suboptimal experience as the primary surgeon. Trainees in both centers agree that they will feel competent to practice neurosurgery upon completion of their training.
This study defined different educational needs for neurosurgical trainees in two centers that reflect both their individual training environments and the local culture of medicine. As such, trainees' perceptions of these needs represent an important adjunct to program evaluation.
发展中国家和发达国家的外科教育都面临挑战。很少有研究系统地考察实习生对自身教育需求的看法。我们开展了一项研究来探讨这个问题,重点关注两个大型培训项目,一个在发达国家,一个在发展中国家。
对加拿大多伦多大学以及印度尼西亚万隆哈桑·萨迪金医院的神经外科实习生进行了问卷调查,该问卷全面评估了他们培训的内容和方法。问卷有37个定量问题,要求在7分李克特量表上作答,还有3个开放式问题以获取更多定性数据。
64%的实习生做出了回应。出现了一些关于培训优缺点的有趣发现。例如,万隆的实习生觉得他们在创伤方面接受了出色的培训,但在专科领域,尤其是脊柱和血管方面则不然,而且作为主刀医生操作的机会很多。多伦多的实习生认为病例的数量和种类都很棒,但他们没有足够的门诊经验,并且作为主刀医生的经验也不太理想。两个中心的实习生都认为,培训结束后他们将有能力从事神经外科工作。
本研究明确了两个中心神经外科实习生不同的教育需求,这些需求既反映了他们各自的培训环境,也反映了当地的医学文化。因此,实习生对这些需求的看法是项目评估的重要补充。