Nuffield Department of Surgery, University of Oxford and Department of Neurosurgery, Oxford University Hospitals, Oxford, United Kingdom.
J Surg Educ. 2013 Jan-Feb;70(1):59-67. doi: 10.1016/j.jsurg.2012.06.019. Epub 2012 Aug 2.
An online portfolio, the Intercollegiate Surgical Curriculum Programme (ISCP; http://www.iscp.ac.uk), became mandatory for British surgical trainees 5 years ago, alongside a compulsory £125 (US$200) annual fee. We previously demonstrated widespread dissatisfaction with its 2008 ver. 5. Here we evaluate and contrast user satisfaction with ver. 8.
DESIGN, SETTING, AND PARTICIPANTS: A total of 359 users across all surgical specialties and UK regions were randomly sampled and surveyed in 2011 by online questionnaire regarding ISCP, elogbook (http://www.elogbook.org.uk), and results compared with 539 users surveyed in 2008. Likert 5-point rating scales were largely used and data analyzed using χ(2) tests.
Seventy-nine percent used ISCP and 38% elogbook (http://www.elogbook.org); 201 responders (56%) evaluated ISCP ver. 8; 31% had registered for at least 1 year, and 59% for 3 years or more. Modal ratings were "average" throughout, with the following percentages of responders rating "poor" or worse vs "good" or better the following domains: registration 12% vs 35%; induction procedure 41% vs. 15%; workplace based assessments 36% vs 22%; peer assessment tool 34% vs 25%; recording meetings 34% vs 19%; Helpdesk 11% vs 40%; user friendliness 29% vs 24%. Trainees were neutral about ISCP's impact upon training and 44% thought that ISCP was needed. Statistically significant (p < 0.05) improvements were seen in user satisfaction with ISCP throughout all domains comparing ver. 8 (2011) to ver. 5 (2008).
The performance of ISCP has improved in the 4 years since its inception with proportionately less negative feedback. British surgeons remain dissatisfied with several of its tools, in particular its workplace-based assessments. Half a decade on, these assessments remain without appropriate evidence of validity despite increasing demands upon trainees to complete quotas of them. With reduced permitted training hours, the growing online bureaucratic burden continues to demoralize busy surgical trainers and trainees.
5 年前，英国外科住院医师培训必须使用在线作品集——大学间外科课程计划（ISCP；http://www.iscp.ac.uk），同时需缴纳 125 英镑（200 美元）的强制性年费。我们之前曾展示过对其 2008 年第 5 版的广泛不满。在这里，我们评估和对比了第 8 版的用户满意度。
设计、环境和参与者：2011 年，我们通过在线问卷对来自所有外科专业和英国各地区的 359 名用户进行了随机抽样调查，内容涉及 ISCP、电子日志（http://www.elogbook.org.uk），并将结果与 2008 年调查的 539 名用户进行了比较。我们主要使用了李克特 5 点量表，并用卡方检验对数据进行了分析。
79%的用户使用 ISCP 和 38%的用户使用电子日志（http://www.elogbook.org.uk）；201 名应答者（56%）对 ISCP 第 8 版进行了评估；31%的用户注册至少 1 年，59%的用户注册 3 年或以上。各领域的应答者评分均为“中等”，评分“差”或“较差”的应答者比例如下：注册 12%比 35%；入职程序 41%比 15%；基于工作场所的评估 36%比 22%；同行评估工具 34%比 25%；记录会议 34%比 19%；服务台 11%比 40%；用户友好度 29%比 24%。住院医师对 ISCP 对培训的影响持中立态度，44%的人认为 ISCP 是必要的。与第 5 版（2008 年）相比，第 8 版（2011 年）在所有领域的用户满意度均有显著提高（p<0.05）。
自成立以来的 4 年中，ISCP 的性能有所提高，负面反馈的比例相应减少。英国外科医生对其多项工具仍不满意，特别是基于工作场所的评估。尽管对住院医师完成评估的配额要求越来越高，但这些评估仍缺乏适当的有效性证据。随着允许的培训时间减少，不断增长的在线官僚负担继续使忙碌的外科培训师和住院医师士气低落。
