Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
J Surg Educ. 2013 May-Jun;70(3):350-6. doi: 10.1016/j.jsurg.2012.11.015.
To design an orientation for surgical interns to meet the new Accreditation Council for Graduate Medical Education Common Program Requirements regarding supervision, to test patient-management competencies, and to assess confidence on skills and tasks pre-orientation and post-orientation.
Twenty-seven incoming surgical interns participated in a two-day orientation to clinical duties. Activities included a pre-test, lectures, simulation, oral examination, intern shadowing, and a post-test. Incoming interns were surveyed before and after orientation and two months later for confidence in patient-management and surgical intern skills. Paired t-tests were used to determine if confidence improved pre-orientation and post-orientation, and two months following orientation.
The study took place at an academic training hospital.
All (n = 27) postgraduate year-1 (PGY-1) surgical residents at our institution, which included the categorical and nondesignated preliminary general surgery, urology, orthopedic surgery, otolaryngology, and neurosurgery programs.
All interns passed the oral and written examinations, and were deemed able to be indirectly supervised, with direct supervision immediately available. They reported increased confidence in all areas of patient management addressed during orientation, and this confidence was retained after two months. In surgical and floor-related tasks and skills, interns reported no increase in confidence directly following orientation. However, after two months, they reported a significant increase in confidence, particularly in those tasks that are performed often.
New requirements for resident supervision require creative ways of verifying resident competency in basic skills. This type of orientation is an effective way to address the new requirements of supervision and teach interns the tasks and skills that are necessary for internship.
设计一种针对外科实习医生的定向培训，以满足新的毕业后医学教育认证委员会普通项目要求，包括监督、测试患者管理能力，并评估实习前和实习后的技能和任务的信心。
27 名新入职的外科实习医生参加了为期两天的临床职责定向培训。活动包括前测、讲座、模拟、口试、实习医生跟随和后测。在定向培训前后以及两个月后，对实习医生进行了关于患者管理和外科实习技能的信心调查。采用配对 t 检验来确定定向培训前后以及定向培训两个月后，信心是否有所提高。
该研究在一家学术培训医院进行。
我们机构所有（n=27）的住院医师规范化培训第一年（PGY-1）外科住院医师，包括分类和非指定的普通外科、泌尿外科、骨科、耳鼻喉科和神经外科项目。
所有实习医生都通过了口试和书面考试，被认为能够间接监督，直接监督随时可用。他们报告说，在定向培训中涉及的所有患者管理领域的信心都有所增强，并且这种信心在两个月后仍然存在。在手术和病房相关的任务和技能方面，实习医生在定向培训后直接报告信心没有增加。然而，两个月后，他们报告说在那些经常执行的任务方面，信心显著增加。
对住院医师监督的新要求需要创造性的方法来验证住院医师在基本技能方面的能力。这种类型的定向培训是一种有效的方法，可以满足监督的新要求，并教授实习医生实习所需的任务和技能。
