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“技艺生疏”:肿瘤专科顾问医生自我报告的实际操作信心下降

'Losing my touch': decline in self-reported confidence in performing practical procedures in consultant oncologists.

作者信息

Thomson A H, Foy C J W, Benstead K

机构信息

Sunrise Centre, Royal Cornwall Hospital, Truro, UK.

出版信息

Med Teach. 2006 Aug;28(5):e139-41. doi: 10.1080/01421590600776669.

Abstract

This study aimed to compare the confidence of oncology consultants and specialist registrars (SpRs) in the performance of practical procedures, to contrast this with confidence in other areas of practice and to determine at what grade they felt most confident. Questionnaires were sent to all 57 oncology consultants and SpRs in the South-West region. Respondents scored confidence on a five-point Likert scale. The response rate was 70%. SpRs were significantly more confident in cardiopulmonary resuscitation (p = 0.003) and central line insertion (p = 0.006). Consultants were significantly more confident in developing management plans (p = 0.001) and performing committee work (p = 0.002). Only 6% of consultants felt most confident performing practical procedures as a consultant, and were less confident about these than other tasks (p = 0.001). Some 86% of SpRs considered they were more confident performing practical procedures as senior house officers (SHOs). In conclusion, self-reported confidence in performing practical procedures declines during career progression in oncology. This raises questions about the teaching and supervision of these procedures. If there is a greater emphasis on a consultant-provided service, their educational needs will need to be recognized and retraining or outsourcing of these procedures to other specialties may be necessary.

摘要

本研究旨在比较肿瘤学顾问医生和专科住院医生(SpRs)在实际操作方面的信心,将其与在其他执业领域的信心进行对比,并确定他们在哪个级别时感觉最有信心。问卷被发送给了西南部地区所有57名肿瘤学顾问医生和SpRs。受访者根据五点李克特量表对信心进行评分。回复率为70%。SpRs在心肺复苏(p = 0.003)和中心静脉置管(p = 0.006)方面明显更有信心。顾问医生在制定管理计划(p = 0.001)和开展委员会工作(p = 0.002)方面明显更有信心。只有6%的顾问医生作为顾问在进行实际操作时感觉最有信心,并且他们对这些操作的信心低于其他任务(p = 0.001)。约86%的SpRs认为他们作为住院医师(SHOs)在进行实际操作时更有信心。总之,在肿瘤学领域,随着职业发展,自我报告的实际操作信心会下降。这引发了关于这些操作的教学和监督的问题。如果更加强调顾问医生提供的服务,就需要认识到他们的教育需求,可能有必要对这些操作进行再培训或将其外包给其他专科。

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