明确初级外科住院医师的教学职责有助于促进教育工作者的发展。

Department of Surgery, University of California, San Francisco, California, USA.

J Surg Educ. 2008 Nov-Dec;65(6):514-7. doi: 10.1016/j.jsurg.2008.07.002.

PURPOSE

Resident-led teaching on surgical services is typically disorganized, and the primary responsibility is often unassigned. Creation of a specified role of "teaching resident" (TR) is hypothesized to encourage residents to teach more, develop leadership skills, and enhance medical student clerkship experiences.

METHODS

All residents in general surgery training at the University of California, San Francisco, were surveyed to determine perceptions of teaching responsibility. Independently, second-year residents were solicited for voluntary participation in a TR program that gave them primary responsibility for teaching medical students assigned to their services during a 1-month rotation. After completion of the TR rotation, these residents evaluated the TR experience with their prior rotation at the same hospital (which had the same service structure but no TR duties). Medical student clerkship evaluations were reviewed to compare experiences between the 2 periods as well.

RESULTS

Overall response rate for the general survey administered to all residents was 93% (67/72). All 6 second-year residents rotating through the designated services over a 6-month period volunteered to participate, but 2 did not have assigned medical students. Evaluations of the TR program were thus completed by 100% (4/4) residents. Time spent teaching medical students increased significantly, from 0.625 hours/week pre-TR to 2.75 hours/week during TR (p = 0.0026). All felt that teaching skills and motivation to teach increased, and 75% also reported improvement in leadership skills. Medical student scores on a 5-point scale revealed an increase in clinical instruction from 2.17 pre-TR to 3.25 (p = 0.0054). Satisfaction of clerkship objectives also increased from 3.17 pre-TR to 3.75 (p = 0.038).

CONCLUSIONS

Junior surgical residents have interest in teaching, and their time spent doing so is significantly increased by the specific assignment of responsibility in a mid-level leadership role. Both residents and students benefit from this clinical service structure. Further formal development and program evaluation are in progress.

目的

住院医师主导的外科服务教学通常缺乏组织，且主要职责往往未明确分配。设立“教学住院医师”（TR）这一特定角色，旨在鼓励住院医师增加教学量、培养领导能力，并提升医学生实习体验。

方法

对加利福尼亚大学旧金山分校普通外科培训项目中的所有住院医师进行调查，以确定他们对教学职责的看法。此外，邀请二年级住院医师自愿参加一个TR项目，该项目让他们在为期1个月的轮转期间，主要负责教授分配到其所在科室的医学生。TR轮转结束后，这些住院医师将此次TR经历与他们之前在同一家医院的轮转经历（服务结构相同但无TR职责）进行了评估。同时，对医学生实习评估进行审查，以比较两个时期的实习体验。

结果

对所有住院医师进行的总体调查的回复率为93%（67/72）。在6个月内轮转通过指定科室的所有6名二年级住院医师均自愿参与，但有2人未分配到医学生。因此，100%（4/4）的住院医师完成了对TR项目的评估。用于教授医学生的时间显著增加，从TR前的每周0.625小时增至TR期间的每周2.75小时（p = 0.0026）。所有人都认为教学技能和教学积极性有所提高，75%的人还报告领导能力有所提升。医学生在5分制评分中的临床指导得分从TR前的2.17提高到3.25（p = 0.0054）。对实习目标的满意度也从TR前的3.17提高到3.75（p = 0.038）。