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加强手术室教学的努力。

Efforts to enhance operating room teaching.

作者信息

Iwaszkiewicz Mary, Darosa Debra A, Risucci Donald A

机构信息

Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

出版信息

J Surg Educ. 2008 Nov-Dec;65(6):436-40. doi: 10.1016/j.jsurg.2008.07.006.

Abstract

OBJECTIVE

To identify the learning needs of faculty members who are not perceived by residents as outstanding teachers in the operating room.

DESIGN

General surgery residents electronically evaluated each faculty surgeon with whom they had significant contact upon completion of each clinical rotation between July 2005 and October 2006. Evaluation forms requested global ratings (1-5 scale ranging from poor to excellent) in 10 separate teaching-related areas, 1 of which was operating room teaching. Residents also rated faculty on 10 specific operating room teaching behaviors identified during a previous observational study.

RESULTS

In total, 134 faculty surgeons were evaluated by 63 residents. Faculty who were evaluated by at least 5 residents (n = 99) were included in the study (mean = 21.9; range, 5-118 evaluations). The ratings of overall operating room teaching (M +/- SD: 4.46 +/- 0.52) correlated significantly (p < 0.001) with ratings of overall performance (r = 0.80) and each of the 10 teaching behaviors (range, r = 0.65 {confident in role as teacher and surgeon} to r = 0.85 {teaches with enthusiasm}). Stepwise multiple regression analysis (R2 = 0.76, p < 0.01) identified ratings of the following teaching behaviors as independently significant predictors (p < 0.05) of global ratings of operating room teaching: allows learners to "feel pathology" (B = 0.38), teaches with enthusiasm (B = 0.31), and remains calm and courteous (B = 0.17).

CONCLUSIONS

Resident perceptions of operating room teaching by faculty surgeons are strongly associated with overall perceptions of the surgeon and with perceptions of specific teaching behaviors exhibited in the operating room. Regression analysis suggests that approximately 76% of the variability in resident evaluations of operating room teaching may be associated with the extent to which a surgeon demonstrates a positive attitude toward teaching, remains calm and courteous, and provides a "hands on" learning experience. Faculty development efforts aimed at operating room teaching that focus on reinforcing or modifying these behaviors may contribute to improved overall perceptions of faculty by residents.

摘要

目的

确定那些未被住院医师视为手术室优秀教师的教员的学习需求。

设计

普通外科住院医师在2005年7月至2006年10月期间完成每次临床轮转后,通过电子方式对与他们有重要接触的每位外科教员进行评估。评估表要求在10个与教学相关的不同领域进行总体评分(1 - 5分,从差到优),其中一个领域是手术室教学。住院医师还对教员在之前一项观察性研究中确定的10种特定手术室教学行为进行评分。

结果

共有63名住院医师对134名外科教员进行了评估。至少被5名住院医师评估的教员(n = 99)被纳入研究(平均 = 21.9;范围,5 - 118次评估)。手术室总体教学评分(M +/- SD:4.46 +/- 0.52)与总体表现评分(r = 0.80)以及10种教学行为中的每一种评分(范围,r = 0.65 {对教师和外科医生角色有信心}至r = 0.85 {教学热情})均显著相关(p < 0.001)。逐步多元回归分析(R2 = 0.76,p < 0.01)确定以下教学行为的评分是手术室教学总体评分的独立显著预测因素(p < 0.05):让学习者“感受病变”(B = 0.38)、教学热情(B = 0.31)以及保持冷静和礼貌(B = 0.17)。

结论

住院医师对外科教员手术室教学的看法与对外科医生的总体看法以及对手术室中表现出的特定教学行为的看法密切相关。回归分析表明,住院医师对手术室教学评估中约76%的变异性可能与外科医生对教学表现出积极态度、保持冷静和礼貌以及提供“实践”学习体验的程度有关。旨在手术室教学的教员发展努力,若专注于强化或改变这些行为,可能有助于住院医师对教员的总体看法得到改善。

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