Department of Surgery, University of Toronto, Ontario, Canada.
Surgery. 2012 Jun;151(6):803-7. doi: 10.1016/j.surg.2012.03.017.
We examined retention rates for basic surgical skills taught through a 1-month intensive laboratory boot camp-style course at the onset of residency.
We present data from 3 groups, each composed of 6 residents. The first group consisted of residents from a new competency-based curriculum (CBC). They started residency training with the Toronto Orthopaedic Boot Camp course. The other 2 groups were junior (JR) and senior (SR) residents from a traditional program whose residency training included no such course. Performance on targeted technical skills was tested using an objective structured assessment of technical skills examination 7 months after the onset of training for the CBC and JR groups and at least 43 months after the onset of training for the SR group.
The mean global rating scale score for the CBC group immediately after the skills course was 4.3, which was maintained 6 months later. There were no significant performance differences between the CBC and SR groups. Both the CBC and SR groups performed significantly better than the JR group (mean global rating scale 3.7; F[2, 15] = 12.269, P < .001).
We conclude that a surgical skills course at the onset of residency is an effective mechanism for teaching targeted technical skills and that skills taught in this manner can have excellent retention rates. Furthermore, an early focus on technical skills allows junior residents to perform at the same level as senior residents for certain tasks and may privilege later learning.
我们考察了在住院医培训初始阶段为期 1 个月的强化实验室集训课程中教授基本外科技能的保留率。
我们呈现了来自 3 组的数据,每组由 6 名住院医组成。第一组是来自新的基于能力的课程(CBC)的住院医。他们从多伦多骨科集训课程开始住院医培训。另外 2 组是来自传统项目的初级(JR)和高级(SR)住院医,他们的住院医培训中没有这样的课程。使用客观结构化临床技能考试来测试针对特定技术技能的表现,该考试在 CBC 和 JR 组开始培训后 7 个月以及 SR 组开始培训后至少 43 个月进行。
CBC 组在技能课程结束后立即的平均整体评分量表得分为 4.3,6 个月后仍保持不变。CBC 组和 SR 组之间没有显著的表现差异。CBC 组和 SR 组的表现均明显优于 JR 组(平均整体评分量表 3.7;F[2, 15] = 12.269,P <.001)。
我们得出结论,住院医培训初始阶段的外科技能课程是教授特定技术技能的有效机制,并且以这种方式教授的技能可以保持优异的保留率。此外,早期关注技术技能可以使初级住院医在某些任务上达到与高级住院医相同的水平,并可能有利于以后的学习。