Department of Vascular Surgery at Indiana University School of Medicine, Indianapolis, IN, USA.
J Vasc Surg. 2012 Feb;55(2):588-97; discussion 598. doi: 10.1016/j.jvs.2011.09.011. Epub 2011 Nov 25.
Methods of learning may differ between generations and even the level of training or the training paradigm, or both. To optimize education, it is important to optimize training designs, and the perspective of those being trained can aid in this quest. The Association of Program Directors in Vascular Surgery leadership sent a survey to all vascular surgical trainees (integrated [0/5], independent current and new graduates [5 + 2]) addressing various aspects of the educational experience. Of 412 surveys sent, 163 (∼40%) responded: 46 integrated, 96 fellows, and 21 graduates. The survey was completed by 52% of the integrated residents, 59% of the independent residents, and 20% of the graduates. When choosing a program for training, the integrated residents are most concerned with program atmosphere and the independent residents with total clinical volume. Concerns after training were thoracic and thoracoabdominal aneurysm procedures and business aspects: 40% to 50% integrated, and 60% fellows/graduates. Integrated trainees found periprocedural discussion the best feedback (79%), with 9% favoring written test review. Surgical training and vascular laboratory and venous training were judged "just right" by 87% and ∼71%, whereas business aspects needed more emphasis (65%-70%). Regarding the 80-hour workweek, 82% felt it prevented fatigue, and 24% thought it was detrimental to patient care. Independent program trainees also found periprocedural discussion the best feedback (71%), with 12% favoring written test review. Surgical training and vascular laboratory/venous training were "just right" by 87% and 60% to 70%, respectively, whereas business aspects needed more emphasis (∼65%-70%). Regarding the 80-hour workweek, 62% felt it was detrimental to patient care, and 42% felt it prevented fatigue. A supportive environment and adequate clinical volume will attract trainees to a program. For "an urgent need to know," the integrated trainees are especially turning to online texts rather than traditional textbooks, which suggests an opportunity for a shift in educational focus. Point-of-care is the best time for education and feedback, suggesting a continued need for dedicated faculty. The business side of training is underserved and should be addressed.
方法的学习可能会因世代而异，甚至培训水平或培训模式也会有所不同。为了优化教育，重要的是要优化培训设计，而受训者的观点可以帮助实现这一目标。血管外科学会项目主任协会向所有血管外科受训者（综合 [0/5]，独立现任和新毕业生 [5+2]）发送了一份调查，涉及教育经验的各个方面。在发送的 412 份调查中，有 163 份（约 40%）做出了回应：46 名综合受训者、96 名研究员和 21 名毕业生。综合住院医师完成了 52%的调查，独立住院医师完成了 59%，而毕业生则完成了 20%。在选择培训项目时，综合住院医师最关心的是项目氛围，而独立住院医师最关心的是总临床量。培训后的关注点是胸和胸腹主动脉瘤手术以及业务方面：40%到 50%的综合住院医师，60%的研究员/毕业生。综合受训者认为围手术期讨论是最好的反馈（79%），而 9%的人赞成书面测试回顾。87%的人认为手术培训和血管实验室/静脉培训恰到好处，约 71%的人认为业务方面需要更多的重视。关于 80 小时的工作周，82%的人认为这可以防止疲劳，而 24%的人认为这对患者护理有害。独立项目的受训者也认为围手术期讨论是最好的反馈（71%），而书面测试回顾则有 12%的人赞成。手术培训和血管实验室/静脉培训分别有 87%和 60%到 70%的人认为恰到好处，而业务方面需要更多的重视（约 65%-70%）。关于 80 小时的工作周，62%的人认为这对患者护理有害，而 42%的人认为这可以防止疲劳。支持性的环境和充足的临床量将吸引受训者到一个项目中。对于“急需了解”，综合受训者特别转向在线文本而不是传统教科书，这表明教育重点可能需要转变。即时反馈是教育和反馈的最佳时机，这表明需要继续配备专门的教师。培训的业务方面服务不足，应该得到解决。
