Nora Institute for Surgical Patient Safety of the American College of Surgeons, Chicago, IL; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL.
J Am Coll Surg. 2013 Nov;217(5):919-23. doi: 10.1016/j.jamcollsurg.2013.07.001. Epub 2013 Sep 13.
As new technology is developed and scientific evidence demonstrates strategies to improve the quality of care, it is essential that surgeons keep current with their skills. Rural surgeons need efficient and targeted continuing medical education that matches their broader scope of practice. Developing such a program begins with an assessment of the learning needs of the rural surgeon. The aim of this study was to assess the learning needs considered most important to surgeons practicing in rural areas.
A needs assessment questionnaire was administered to surgeons practicing in rural areas. An additional gap analysis questionnaire was administered to registrants of a skills course for rural surgeons.
Seventy-one needs assessment questionnaires were completed. The self-reported procedures most commonly performed included laparoscopic cholecystectomy (n = 44), hernia repair (n = 42), endoscopy (n = 43), breast surgery (n = 23), appendectomy (n = 20), and colon resection (n = 18). Respondents indicated that they would most like to learn more skills related to laparoscopic colon resection (n = 16), laparoscopic antireflux procedures (n = 6), laparoscopic common bile duct exploration/ERCP (n = 5), colonoscopy/advanced techniques and esophagogastroscopy (n = 4), and breast surgery (n = 4). Ultrasound, hand surgery, and leadership and communication were additional topics rated as useful by the respondents. Skills course participants indicated varying levels of experience and confidence with breast ultrasound, ultrasound for central line insertion, hand injury, and facial soft tissue injury.
Our results demonstrated that surgeons practicing in rural areas have a strong interest in acquiring additional skills in a variety of general and subspecialty surgical procedures. The information obtained in this study may be used to guide curriculum development of further postgraduate skills courses targeted to rural surgeons.
随着新技术的发展和科学证据表明可以改善护理质量的策略，外科医生必须不断更新自己的技能。农村外科医生需要高效且针对性强的继续医学教育，以满足他们更广泛的实践范围。开发这样的计划首先要评估农村外科医生的学习需求。本研究的目的是评估农村地区外科医生认为最重要的学习需求。
向农村地区执业的外科医生发放需求评估问卷。还向农村外科医生技能课程的注册人员发放了额外的差距分析问卷。
完成了 71 份需求评估问卷。自我报告的最常进行的手术包括腹腔镜胆囊切除术（n = 44）、疝修补术（n = 42）、内镜检查（n = 43）、乳房手术（n = 23）、阑尾切除术（n = 20）和结肠切除术（n = 18）。受访者表示，他们最希望学习更多与腹腔镜结肠切除术（n = 16）、腹腔镜抗反流手术（n = 6）、腹腔镜胆总管探查/ERCP（n = 5）、结肠镜检查/高级技术和食管胃十二指肠镜检查（n = 4）和乳房手术（n = 4）相关的技能。超声、手外科和领导力与沟通也是受访者认为有用的附加主题。技能课程参与者表示，他们在乳房超声、用于中央静脉置管的超声、手部损伤和面部软组织损伤方面的经验和信心程度不一。
我们的结果表明，在农村地区执业的外科医生对获得各种普通和亚专业手术技能有强烈的兴趣。本研究获得的信息可用于指导针对农村外科医生的进一步研究生技能课程的课程开发。
