Department of Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
J Surg Educ. 2012 Sep-Oct;69(5):617-22. doi: 10.1016/j.jsurg.2012.03.001. Epub 2012 Apr 17.
Basic surgical skills are frequently taught to surgical interns in simulation centers. Faculty recruitment for teaching of these sessions can be difficult. The goal of this study was to determine whether senior surgical residents can effectively teach basic surgical skills to provide an alternative to faculty-led instruction.
DESIGN, SETTING, AND PARTICIPANTS: Academic medical center. Twenty-eight surgical interns. In this randomized controlled trial, interns were randomized to receive teaching by either faculty or senior residents. Two-hour teaching sessions for each group consisted of modeling and guided practice. All interns underwent baseline knot-tying and suturing skill assessment using a previously validated standardized task scoring scheme and completed a confidence survey. After teaching sessions, both groups underwent repeated skill testing and were again surveyed.
Twenty-eight interns started in the surgery program at our institution during the year of this study. Seventeen of 27 (62.9%) interns participated in both teaching sessions and completed all skill assessments and surveys; 7 (41.2%) interns were taught by faculty, 10 (58.8%) by residents. Overall, skills training improved in both groups for knot-tying, running suture, and subcuticular suture performance. Confidence performing knot-tying tasks also improved. Interns taught by faculty members and residents demonstrated similar levels of improvement in speed and accuracy, although faculty instruction improved speed of performing the simple suturing task (-144 vs -27 s, p = 0.04).
In the simulation center, teaching by senior surgical residents and faculty members resulted in comparable improvement in interns' basic surgical skills. These findings could increase the skill instructor pool for teaching in the simulation center, potentially easing recruitment and providing senior residents with teaching opportunities.
基础外科技能经常在模拟中心教授给外科实习医师。这些课程的教师招聘可能具有挑战性。本研究的目的是确定高级外科住院医师是否可以有效地教授基本外科技能，以提供替代教师主导教学的方法。
设计、地点和参与者：学术医疗中心。28 名外科实习医师。在这项随机对照试验中，实习医师被随机分配接受教师或高级住院医师的教学。两组各进行两小时的教学，包括示范和指导实践。所有实习医师均使用先前验证的标准化任务评分方案进行基线打结和缝合技能评估，并完成信心调查。在教学课程之后，两组均接受重复技能测试并再次进行调查。
在本研究年度，我院有 28 名实习医师开始参加外科培训计划。27 名实习医师中的 17 名（62.9%）参加了两次教学课程并完成了所有技能评估和调查；7 名（41.2%）由教师授课，10 名（58.8%）由住院医师授课。总体而言，两组的打结、连续缝合和皮内缝合的技能训练都有所提高。打结任务的信心也有所提高。接受教师和住院医师授课的实习医师在速度和准确性方面的提高程度相似，尽管教师指导提高了简单缝合任务的速度（-144 与-27 秒，p=0.04）。
在模拟中心，高级外科住院医师和教师的教学可使实习医师的基本外科技能得到相似程度的提高。这些发现可以增加模拟中心教学的技能指导者人数，可能会缓解招聘压力，并为高级住院医师提供教学机会。
