Mahoney Adam, Crowe Philip J, Harris Peter
University of New South Wales, Prince of Wales Hospital, Australia.
ANZ J Surg. 2010 Dec;80(12):884-9. doi: 10.1111/j.1445-2197.2010.05430.x. Epub 2010 Aug 16.
Surgical trainees' operating theatre (OT) experiences significantly influence their ability to attain key professional competencies. A measure of trainees' satisfaction with this learning environment would allow recognition of characteristics of highly successful teaching venues and threats to trainee development. Our study aimed to validate the Surgical Theatre Educational Environment Measure (STEEM) and use it to explore Australasian surgical trainees' satisfaction with OT learning.
In a cross-sectional study, the STEEM was distributed electronically to all 1500 Royal Australasian College of Surgeons trainees in Australia and New Zealand. Trainee satisfaction was gauged using Likert-type items, an overall satisfaction measure and content analysis of free-text comments. The STEEM's psychometric properties were evaluated using exploratory factor analysis.
Three hundred fifty-six responses were received. The STEEM's original subscales were not supported by the data; empirically grounded subscales were identified for further analysis. Most trainees were satisfied with their OT environment and satisfaction was higher in senior than junior trainees. Trainees' relationship with their supervisor correlated most strongly with overall satisfaction. Less positively, only half of trainees report discussing their operative role with their supervisor prior to surgery.
The a priori STEEM subscales could not be replicated by factor analysis. We developed an empirically grounded instrument capable of identifying areas of trainee concern. The majority of trainees reported high levels of satisfaction. The revised instrument has potential to complement other sources of information to facilitate surgical supervisors' difficult task of optimizing trainees' compatibility with their OT learning environments.
外科实习医生的手术室（OT）经历对他们获得关键专业能力的能力有重大影响。衡量实习医生对这种学习环境的满意度，有助于识别非常成功的教学场所的特点以及对实习医生发展的威胁。我们的研究旨在验证手术室教育环境测量工具（STEEM），并使用它来探索澳大利亚和新西兰外科实习医生对手术室学习的满意度。
在一项横断面研究中，通过电子方式向澳大利亚和新西兰的1500名皇家澳大利亚外科学院实习医生发放了STEEM。使用李克特式项目、总体满意度测量以及对自由文本评论的内容分析来衡量实习医生的满意度。使用探索性因素分析来评估STEEM的心理测量特性。
共收到356份回复。数据不支持STEEM原来的子量表；确定了基于实证的子量表以供进一步分析。大多数实习医生对他们的手术室环境感到满意，高级实习医生的满意度高于初级实习医生。实习医生与他们的上级的关系与总体满意度的相关性最强。不太乐观的是，只有一半的实习医生报告在手术前与上级讨论过他们的手术角色。
先验的STEEM子量表无法通过因素分析复制。我们开发了一种基于实证的工具，能够识别实习医生关注的领域。大多数实习医生报告了较高的满意度。修订后的工具有可能补充其他信息来源，以促进外科上级优化实习医生与手术室学习环境匹配度这项艰巨任务。
