Greene Brittany, Head Linden, Gawad Nada, Hamstra Stanley J, McLean Laurie
University of Ottawa Faculty of Medicine, 451 Smyth Road, Ottawa, Canada.
University of Toronto Department of Surgery, Faculty of Medicine, 1 King's College Circle, Medical Sciences Building, Room 2109, Toronto, Canada.
J Otolaryngol Head Neck Surg. 2015 Feb 3;44(1):3. doi: 10.1186/s40463-015-0059-5.
There is significant variability in undergraduate Otolaryngology - Head and Neck Surgery (OTOHNS) curricula across Canadian medical schools. As part of an extracurricular program delivered jointly with other surgical specialties, the Surgical Exploration and Discovery (SEAD) program presents an opportunity for medical students to experience OTOHNS. The purpose of this study is to review the participation and outcome of OTOHNS in the SEAD program.
The SEAD program is a two-week, 80-hour, structured curriculum that exposes first-year medical students to nine surgical specialties across three domains: (1) operating room observerships, (2) career discussions with surgeons, and (3) simulation workshops. During observerships students watched or assisted in surgical cases over a 4-hour period. The one-hour career discussion provided a specialty overview and time for students' questions. The simulation included four stations, each run by a surgeon or resident; students rotated in small groups to each station: epistaxis, peritonsillar abscess, tracheostomy, and ear examination. Participants completed questionnaires before and after the program to evaluate changes in career interests; self-assessment of knowledge and skills was also completed following each simulation. Baseline and final evaluations were compared using the Wilcoxon Signed-Rank test.
SEAD participants showed significant improvement in knowledge and confidence in surgical skills specific to OTOHNS. The greatest knowledge gain was in ear examination, and greatest gain in confidence was in draining peritonsillar abscesses. The OTOHNS session received a mean rating of 4.8 on a 5-point scale and was the most popular surgical specialty participating in the program. Eight of the 18 participants were interested in OTOHNS as a career at baseline; over the course of the program, two students gained interest and two lost interest in OTOHNS as a potential career path, demonstrating the potential for helping students refine their career choice.
Participants were able to develop OTOHNS knowledge and surgical skills as well as refine their perspective on OTOHNS as a potential career option. These findings demonstrate the potential benefits of OTOHNS departments/divisions implementing observerships, simulations, and career information sessions in pre-clerkship medical education, either in the context of SEAD or as an independent initiative.
加拿大各医学院校的本科耳鼻喉头颈外科学(OTOHNS)课程存在显著差异。作为与其他外科专业联合开展的课外项目的一部分,外科探索与发现(SEAD)项目为医学生提供了体验OTOHNS的机会。本研究的目的是回顾SEAD项目中OTOHNS的参与情况和结果。
SEAD项目是一个为期两周、共80小时的结构化课程,让一年级医学生接触三个领域的九个外科专业:(1)手术室观摩,(2)与外科医生进行职业讨论,(3)模拟工作坊。在观摩期间,学生们在4小时内观看或协助手术病例。1小时的职业讨论提供了专业概述并留出时间供学生提问。模拟包括四个站点,每个站点由一名外科医生或住院医师负责;学生们以小组形式轮流到每个站点:鼻出血、扁桃体周围脓肿、气管切开术和耳部检查。参与者在项目前后完成问卷以评估职业兴趣的变化;每次模拟后还完成了知识和技能的自我评估。使用Wilcoxon符号秩检验比较基线评估和最终评估。
SEAD参与者在OTOHNS特定的手术技能知识和信心方面有显著提高。知识增长最多的是耳部检查,信心增长最多的是引流扁桃体周围脓肿。OTOHNS课程在5分制中的平均评分为4.8,是参与该项目中最受欢迎的外科专业。18名参与者中有8人在基线时对OTOHNS作为职业感兴趣;在项目过程中,有两名学生对OTOHNS作为潜在职业道路产生了兴趣,两名学生失去了兴趣,这表明该项目有帮助学生完善职业选择的潜力。
参与者能够培养OTOHNS知识和手术技能,并完善他们对OTOHNS作为潜在职业选择的看法。这些发现表明,OTOHNS科室/部门在临床前医学教育中实施观摩、模拟和职业信息课程,无论是在SEAD项目背景下还是作为一项独立举措,都具有潜在益处。