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当前外科住院医师团队培训的理念:对北美项目主任的调查。

Current concepts of team training in surgical residency: a survey of North American program directors.

机构信息

Division of General Surgery, St. Michael's Hospital, Toronto, Canada.

出版信息

J Surg Educ. 2013 Sep-Oct;70(5):578-84. doi: 10.1016/j.jsurg.2013.04.011. Epub 2013 May 30.

Abstract

OBJECTIVES

The purpose of the present survey was to (1) establish the prevalence of Crew Resource Management (CRM)- and team-training interventions among general surgery residency programs of the United States and Canada; (2) to characterize current approaches to training and assessment of nontechnical skills; and (3) to inquire about program directors' (PDs') recommendations for future curricula in graduate medical education.

DESIGN

An online questionnaire was developed by the authors and distributed via email to the directors of all accredited general surgery residency programs across the United States and Canada. After 3 email reminders, paper versions were sent to all nonresponders.

PARTICIPANTS AND SETTING

PDs of accredited general surgery residency programs in the United States and Canada.

RESULTS

One hundred twenty (47%) PDs from the United States and 9 (53%) from Canada responded to the survey. Of all respondents, 32% (n = 40) indicated conducting designated team-training interventions for residents. Three main instructional strategies were identified: combined approaches using simulation and didactic methods (42%, n = 16); predominantly simulation-based approaches (37%, n = 14); and didactic approaches (21%, n = 8). Correspondingly, 83% (n = 93) of respondents recommended a combination of didactic methods and opportunities for practice for future curricula. A high agreement between responding PDs was shown regarding learning objectives for a proposed team-based training curriculum (α = 0.95).

CONCLUSIONS

The self-reported prevalence of designated CRM- and team-training interventions among responding surgical residency programs was low. For the design of future curricula, the vast majority of responding PDs advocated for the combination of interactive didactic methods and opportunities for practice.

摘要

目的

本调查的目的是:(1)确定美国和加拿大普通外科住院医师培训计划中船员资源管理(CRM)和团队培训干预措施的流行程度;(2)描述当前非技术技能培训和评估方法;(3)询问项目主任(PD)对研究生医学教育未来课程的建议。

设计

作者开发了一个在线问卷,并通过电子邮件分发给美国和加拿大所有认证的普通外科住院医师培训计划的主任。在发出 3 封电子邮件提醒后,将纸质版本发送给所有未回复的人。

参与者和设置

美国和加拿大认证的普通外科住院医师培训计划的主任。

结果

美国的 120 名(47%)PD 和加拿大的 9 名(53%)PD 对调查做出了回应。在所有受访者中,32%(n=40)表示为居民开展指定的团队培训干预措施。确定了三种主要的教学策略:使用模拟和理论方法的综合方法(42%,n=16);主要基于模拟的方法(37%,n=14);和理论方法(21%,n=8)。相应地,83%(n=93)的受访者建议为未来课程提供理论方法和实践机会的组合。对于拟议的基于团队的培训课程,回应的 PD 之间表现出高度一致的学习目标(α=0.95)。

结论

报告的回应外科住院医师培训计划中指定的 CRM 和团队培训干预措施的流行率较低。对于未来课程的设计,绝大多数回应的 PD 提倡将互动理论方法和实践机会结合起来。

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