Bhatti Nasir I, Ahmed Aadil, Choi Sukgi S
Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A.
Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
Laryngoscope. 2015 Dec;125(12):2685-9. doi: 10.1002/lary.25262. Epub 2015 Apr 15.
OBJECTIVES/HYPOTHESIS: Evidence shows a positive association between quality of surgical training received and patient outcomes. Traditionally, improved patient outcomes are linked with increased operative volume. However, generalizing this finding to surgeons in training is unclear. In addition, reduced exposure due to work-hour restrictions calls for alternative methods to determine the quality of training. The purpose of this study was to identify the indicators of high-quality training by surveying the trainees and trainers.
A questionnaire was developed based on input from faculty and previous studies. The survey was divided into three sections asking about the indicators of quality training, methods to measure them, and interventions for improvement. The questionnaire was administered to program directors (PDs) and senior residents of otolaryngology training programs nationwide.
The strongest indicators of quality training that were agreed upon by both residents and PDs were having faculty development as an ideal trainer while having a balanced level of supervision and independence, logbooks for exposure to volume and variety of pathology, continuous evaluation and provision of feedback. However, structured teaching, simulation-based training, and trainee exam scores failed to reach an agreement as a metric of high-quality surgical training.
Measuring quality of a residency training program is imperative to produce competent surgeons and ensuring patient safety. The results of this study will help the residency programs to better train their residents and improve the quality of their teaching.
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目的/假设：证据表明，所接受的外科培训质量与患者预后之间存在正相关。传统上，患者预后的改善与手术量的增加有关。然而，将这一发现推广到正在接受培训的外科医生身上尚不清楚。此外，由于工作时间限制导致的接触减少，需要采用替代方法来确定培训质量。本研究的目的是通过对学员和培训师进行调查，确定高质量培训的指标。
根据教员的意见和以往的研究制定了一份问卷。该调查分为三个部分，询问质量培训的指标、衡量这些指标的方法以及改进措施。该问卷面向全国耳鼻喉科培训项目的项目主任（PDs）和高级住院医师发放。
住院医师和项目主任都认可的质量培训最强指标包括，将教员发展作为理想的培训方式，同时具备平衡的监督和独立水平，记录接触病例数量和病理类型的日志，持续评估和反馈。然而，结构化教学、模拟培训和学员考试成绩未能作为高质量外科培训的指标达成共识。
衡量住院医师培训项目的质量对于培养合格的外科医生和确保患者安全至关重要。本研究结果将有助于住院医师培训项目更好地培训其住院医师并提高教学质量。
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