Burkholder Hans C, Cofer Joseph B
Department of Surgery, University of Tennessee, Chattanooga, TN 37403, USA.
J Am Coll Surg. 2007 Mar;204(3):416-21. doi: 10.1016/j.jamcollsurg.2006.12.014.
Differences have been established between rural and urban surgery with regard to surgeon supply, demographics, and practices. This study attempts to determine the importance and prevalence of rural surgery training in American general surgery residency programs.
A survey was electronically submitted to and completed by surgery program directors in the fall of 2004. Respondents were divided into research or nonresearch programs. Survey items measured attitudes toward the necessity and ideal components of a rural surgery curriculum and whether or not the program had such a curriculum in place.
There was a 24.0% survey response rate, with 17.2% of respondents being classified as research programs. Research programs were less likely to believe that it was their mission to train rural surgeons (2.50 versus 4.36, p < 0.001) and were less likely to believe that a shortage of rural surgeons exists. Just over 36% of programs reported having a rural surgery curriculum. Programs that believed training rural surgeons was part of their mission and that believed such a curriculum was necessary to train rural surgeons were more likely to have a rural surgery curriculum in place.
The presence of a curriculum to train rural surgeons is related to the belief that such a curriculum is necessary and that training rural surgeons is part of that residency program's mission. Residency programs have different attitudes and practices with regard to rural surgery training. Development of a rural surgery training designation can help trainees wishing to practice in a rural environment identify the programs best suited to equip them to do so.
农村和城市外科手术在外科医生供应、人口统计学和手术操作方面已存在差异。本研究旨在确定美国普通外科住院医师培训项目中农村外科手术培训的重要性和普遍性。
2004年秋季,通过电子方式向手术项目主任发送并完成了一项调查。受访者分为研究型或非研究型项目。调查项目衡量了对农村外科手术课程必要性和理想组成部分的态度,以及该项目是否设有此类课程。
调查回复率为24.0%,17.2%的受访者被归类为研究型项目。研究型项目不太可能认为培训农村外科医生是其使命(2.50对4.36,p<0.001),也不太可能认为存在农村外科医生短缺的情况。略多于36%的项目报告设有农村外科手术课程。认为培训农村外科医生是其使命一部分且认为此类课程对培训农村外科医生必不可少的项目,更有可能设有农村外科手术课程。
设有培训农村外科医生的课程与认为此类课程有必要以及培训农村外科医生是该住院医师培训项目使命一部分的信念有关。住院医师培训项目在农村外科手术培训方面有不同的态度和做法。制定农村外科手术培训指定标准有助于希望在农村环境中执业的学员识别最适合为其提供相应培训的项目。