手术室中外科医生指导行为的分类法。
A taxonomy of surgeons' guiding behaviors in the operating room.
作者信息
Chen Xiaodong Phoenix, Williams Reed G, Sanfey Hilary A, Smink Douglas S
机构信息
Department of Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Department of Surgery, Indiana University, 545 Barnhill Drive, Indianapolis, IN 46202.
出版信息
Am J Surg. 2015 Jan;209(1):15-20. doi: 10.1016/j.amjsurg.2014.07.018. Epub 2014 Nov 7.
BACKGROUND
This study explores the nature and the intention of attending surgeons' guiding behaviors performed in the operating room (OR) in order to build taxonomy of OR guiding behavior.
METHODS
Nine attending surgeons and 8 surgical residents were invited to observe 8 prerecorded surgical cases from 4 common procedures and completed semistructured interviews. All video-based observations were videotaped. Thematic analysis was applied to identify surgeons' OR guiding behavior.
RESULTS
Seven hundred eighty minutes of video-based observations with interviews were conducted. Sixteen types of OR guiding behaviors in 3 intention-based categories were identified: 3 of the 16 was "teaching" (18.75%), 8 of the 16 was "directing" (50%), and 5 of the 16 was "assisting" (31.25%).
CONCLUSIONS
Surgeons' OR guiding behaviors were grounded in 3 behavioral intentions: teaching, directing, and assisting. This taxonomy of OR guiding behavior can be used as a basis for developing OR guiding strategy to improve residents' intraoperative competency, autonomy, and independence.
背景
本研究旨在探究主刀医生在手术室的引导行为的本质和意图，以构建手术室引导行为分类法。
方法
邀请9位主刀医生和8位外科住院医师观察4种常见手术的8个预先录制的手术病例，并完成半结构化访谈。所有基于视频的观察均进行了录像。采用主题分析法确定外科医生的手术室引导行为。
结果
进行了780分钟的基于视频的观察并进行访谈。确定了基于3种意图的16种手术室引导行为类别：16种行为中有3种是“教学”（18.75%），16种行为中有8种是“指导”（50%），16种行为中有5种是“协助”（31.25%）。
结论
外科医生的手术室引导行为基于3种行为意图：教学、指导和协助。这种手术室引导行为分类法可作为制定手术室引导策略的基础，以提高住院医师的术中能力、自主性和独立性。
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