Division of Research, Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.
J Surg Res. 2011 Oct;170(2):195-201. doi: 10.1016/j.jss.2011.03.046. Epub 2011 Apr 16.
Student observation of surgical procedures is standard practice performed at the discretion of the attending surgeon and the participating medical facility. The goal of our study was to evaluate patient, physician, and operating room (OR) staff opinions concerning student observation of surgical procedures at different levels of academic training.
Following Institutional Review Board approval, patients undergoing elective surgery were consented to participate in the survey. An anonymous online survey was sent to attending surgeons and OR staff.
The majority of patients (97), physicians (91), and OR staff (71) believe that OR observational experience is important to medical student training. Patients (92%) and OR staff (97%) more so than physicians (72%) rated OR observational experience as important for nursing student education (P < 0.001). Comparatively, all groups believe this experience is less important for college and high school students (P < 0.01). When asked if patients should be informed preoperatively of student-observer presence during procedures, more patients and OR staff replied affirmatively compared with physicians (P < 0.001). Similarly, patients and OR staff more frequently believed that informed consent for OR student-observers was necessary (P < 0.0001).
All groups acknowledged the educational value of student observational experience, although significant disparity was noted relative to academic level and the group responding. Additionally, opinions of the OR staff were more closely aligned with those of patients. Further assessment of the role of informed consent for student-observer OR presence and potential implications is needed.
学生观察手术过程是一种标准做法,由主治外科医生和参与的医疗设施自行决定。我们研究的目的是评估患者、医生和手术室(OR)工作人员对不同学术培训水平的学生观察手术过程的看法。
在获得机构审查委员会批准后,征得接受择期手术的患者同意参与调查。向主治外科医生和 OR 工作人员发送了匿名在线调查。
大多数患者(97%)、医生(91%)和 OR 工作人员(71%)认为 OR 观察经验对医学生培训很重要。患者(92%)和 OR 工作人员(97%)比医生(72%)更认为 OR 观察经验对护理学生教育很重要(P < 0.001)。相比之下,所有组都认为这种经验对大学生和高中生来说不太重要(P < 0.01)。当被问及患者是否应该在手术前被告知手术过程中有学生观察者时,更多的患者和 OR 工作人员的回答是肯定的,而不是医生(P < 0.001)。同样,患者和 OR 工作人员更频繁地认为有必要获得 OR 学生观察者的知情同意(P < 0.0001)。
所有组都承认学生观察经验的教育价值,尽管相对于学术水平和回应的组,存在显著差异。此外,OR 工作人员的意见与患者的意见更为一致。需要进一步评估学生观察者 OR 存在的知情同意的作用及其潜在影响。