Marshall Dominic C, Salciccioli Justin D, Walton Sarah-Jane, Pitkin Joan, Shalhoub Joseph, Malietzis George
Imperial College London, London, United Kingdom.
Imperial College London, London, United Kingdom.
J Surg Educ. 2015 May-Jun;72(3):438-45. doi: 10.1016/j.jsurg.2014.10.018. Epub 2014 Dec 24.
Student experiences during surgical rotations may dictate interest in future surgical careers. The objective of this study was to systematically examine the effect of surgical experience (SE) on student attitudes toward surgical careers and also to identify variables influencing the educational value of SE.
A systematic review of the available literature was conducted by 2 independent researchers searching Medline, EMBASE, Google Scholar, and Cochrane databases, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses recommendations. Studies assessing SE during the students' surgical rotations were identified. The quality of the included studies was assessed using a validated quality index. Factors affecting student surgical rotation experience and perceptions of surgical careers were recorded.
Overall, 204 studies were identified; 20 unique studies met the inclusion criteria with a median cohort size of 169 (interquartile range: 107-262) respondents. Most were cross-sectional surveys (n = 16/20) and administered to clinical students (n = 16/20). All studies investigating the effect of SE on career choices (n = 8) found that positive experiences during the surgical placement were associated with an increased interest in surgical careers. The operating theater experience was identified as a defining feature of overall SE. Involvement in operative procedures, a welcoming environment, and avoidance of syncopal events positively influenced the SE, particularly in those who actively sought educational opportunities. Study limitations included single-center and single-year cohort designs (70%) with the use of nonvalidated research tools (95%).
A systematic review of the literature highlights a number of factors associated with a positive surgical rotation, which may lead to more students deciding to pursue a career in surgery. Understanding the factors that contribute to these decisions through multicenter studies using validated research tools may lead to more effective surgical rotations, ultimately improving the delivery of the surgical education.
学生在外科轮转期间的经历可能会决定其未来从事外科职业的兴趣。本研究的目的是系统地考察外科经历（SE）对学生对外科职业态度的影响，并确定影响SE教育价值的变量。
由2名独立研究人员按照系统评价和Meta分析的首选报告项目建议，检索Medline、EMBASE、谷歌学术和Cochrane数据库，对现有文献进行系统评价。纳入评估学生外科轮转期间SE的研究。使用经过验证的质量指数评估纳入研究的质量。记录影响学生外科轮转经历和对外科职业看法的因素。
总体而言，共识别出204项研究；20项独特研究符合纳入标准，中位队列规模为169名（四分位间距：107 - 262）受访者。大多数是横断面调查（n = 16/20），并针对临床学生进行（n = 16/20）。所有调查SE对职业选择影响的研究（n = 8）均发现，外科实习期间的积极经历与对外科职业的兴趣增加相关。手术室经历被确定为总体SE的一个决定性特征。参与手术操作、良好的环境以及避免晕厥事件对外科经历有积极影响，尤其是对那些积极寻求教育机会的学生。研究局限性包括单中心和单年度队列设计（70%）以及使用未经验证的研究工具（95%）。
对文献的系统评价突出了一些与积极的外科轮转相关的因素，这可能会使更多学生决定从事外科职业。通过使用经过验证的研究工具进行多中心研究来了解促成这些决定的因素，可能会带来更有效的外科轮转，最终改善外科教育的实施。
