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在一家大都市三级妇产科医院引入并验证一种手术会诊模板,以促进对妇科医生的手术指导。

The introduction and the validation of a surgical encounter template to facilitate surgical coaching of gynaecologists at a metropolitan tertiary obstetrics and gynaecology hospital.

作者信息

Leung Yee, Salfinger Stuart, Tan Jason Jit-Sun, Frazer Amanda

机构信息

School of Women's and Infants' Health, The University of Western Australia, Subiaco, Western Australia, Australia.

出版信息

Aust N Z J Obstet Gynaecol. 2013 Oct;53(5):477-83. doi: 10.1111/ajo.12116. Epub 2013 Jul 31.

DOI:10.1111/ajo.12116
PMID:23902272
Abstract

INTRODUCTION

At a metropolitan tertiary obstetrics and gynaecology hospital some gynaecologists identified a need for surgical coaching. Full-time specialists in a teaching hospital are expected to teach surgery whilst having limited access to improving their own surgical skills. Over time, this resulted in some degree of technical deskilling. This in turn led to a loss of confidence in their technical ability to perform complex procedures. The trainee was potentially taught surgery by gynaecologists who were not confident in some aspects of their own surgical skill.

METHODS

A pilot program was introduced to validate a structured surgical encounter template to facilitate surgical coaching in a dedicated regular operating list.

RESULTS

There was a high degree of satisfaction amongst participants in the program. Learning objectives were predominantly related to acquisition of psychomotor skills, but cognitive and affective skills were also identified. Participants felt they gained confidence and improved their surgical skill as a result of the program. The descriptive feedback validated the structured encounter template in facilitating the learning and teaching environment in the operating room. Most participants expressed an intention to adopt a more structured approach in their surgical teaching.

DISCUSSION

A structured surgical coaching template used in a surgical coaching program facilitated short-term self-perceived improvement in surgical skill and confidence. Participants also expressed an intention to introduce a more structured approach in their teaching. The structured programme using the encounter template may have a potential role in remediating a surgeon identified as an outlier by a credentialing body.

摘要

引言

在一家大都市的三级妇产科医院,一些妇科医生发现了手术指导的需求。教学医院的全职专家既要教授手术,又很少有机会提升自己的手术技能。随着时间的推移,这导致了一定程度的技术生疏。这进而导致他们对自己执行复杂手术的技术能力失去信心。实习生可能由那些对自己某些手术技能方面缺乏信心的妇科医生来教授手术。

方法

引入了一个试点项目,以验证一个结构化的手术诊疗模板,以便在专门的常规手术安排中促进手术指导。

结果

该项目的参与者满意度很高。学习目标主要与获得心理运动技能相关,但也涉及认知和情感技能。参与者认为,通过该项目他们获得了信心,提高了手术技能。描述性反馈验证了结构化诊疗模板在促进手术室学习和教学环境方面的作用。大多数参与者表示打算在手术教学中采用更结构化的方法。

讨论

手术指导项目中使用的结构化手术指导模板促进了手术技能和信心的短期自我认知提升。参与者还表示打算在教学中引入更结构化的方法。使用诊疗模板的结构化项目可能在纠正被资质认证机构认定为表现异常的外科医生方面发挥潜在作用。

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