Department of Surgery, Southern Illinois University School of Medicine, PO Box 19638, Springfield, IL 62794, USA.
Am J Surg. 2012 Jan;203(1):44-8. doi: 10.1016/j.amjsurg.2011.09.003. Epub 2011 Nov 9.
This study explored the amount of guidance provided to residents in the operating room (OR) and the relationship of OR guidance with postgraduate year (PGY) and operative performance rating (OPR).
We used OPR instruments to collect data from supervising surgeons after each performance. External expert raters blindly rated the amount of guidance for 5 videotaped performances.
Three hundred sixty-eight performances were analyzed for 5 procedures performed by 26 residents with 16 supervising surgeons over 6 months. Guidance ratings varied with procedure, individual supervising surgeons varied in the amount of guidance reported, the amount of guidance decreased as residents' PGY level increased, and the correlation between guidance rating and overall performance was .62. In comparison cases, most supervising surgeons underestimated the amount of guidance provided.
Controlling for the amount of supervising surgeon guidance has important implications for training and evaluation as we strive to prepare residents to practice independently.
本研究探讨了手术室（OR）中向住院医师提供的指导量，以及 OR 指导与住院医师年级（PGY）和手术绩效评分（OPR）的关系。
我们使用 OPR 工具在每次手术完成后从主刀医生那里收集数据。外部专家评估员对 5 段录像手术的指导量进行了盲评。
在 6 个月的时间里，对 26 名住院医师进行的 5 种手术的 368 次手术进行了分析，共有 16 名主治医生参与。指导评分因手术而异，每位主治医生报告的指导量也有所不同，随着住院医师 PGY 水平的提高，指导量逐渐减少，指导评分与整体绩效的相关性为.62。在对比案例中，大多数主治医生低估了提供的指导量。
控制主治医生指导的数量对培训和评估具有重要意义，因为我们努力使住院医师能够独立执业。
