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脊柱手术错误部位预防培训。

Prevention training of wrong-site spine surgery.

作者信息

Mesfin Addisu, Canham Colin, Okafor Louis

机构信息

Department of Orthopaedic Surgery and Rehabilitation, University of Rochester School of Medicine and Dentistry, Rochester, New York.

Department of Orthopaedic Surgery and Rehabilitation, University of Rochester School of Medicine and Dentistry, Rochester, New York.

出版信息

J Surg Educ. 2015 Jul-Aug;72(4):680-4. doi: 10.1016/j.jsurg.2015.01.010. Epub 2015 Apr 15.

Abstract

OBJECTIVE

Wrong-site surgery (WSS) is considered a sentinel event by the Joint Commission. The education of spine surgery fellows on WSS is unknown. Our objective was to evaluate North American spine surgery fellows' education, awareness, and experience with WSS.

DESIGN

Observational survey study.

SETTING

Spine surgery fellows in North America.

PARTICIPANTS

From April 2013 to July 2013 and in July 2014 anonymous questionnaires were sent to 156 spine surgery fellows participating in 75 programs. Demographic information (fellowship location and Accreditation Council for Graduate Medical Education accreditation of the fellowship) were collected. We also collected data on the following: if didactics on WSS are offered during fellowship, spine surgery fellows' experience with WSS, WSS prevention methods used during fellowship, and whether spine surgery fellows are interested in didactics or webinars on the prevention of WSS.

RESULTS

Of 152 spine surgery fellows, 46 (30.3%) completed the questionnaires. Among them, 39 (84.6%) were orthopedic surgeons and 7 (15.4%) were neurosurgeons. Most were in non-Accreditation Council for Graduate Medical Education-accredited programs (70%) and were in training in the Midwest (37%), the South (30.4%), the Northeast (15.2%), and the West (15.2%). Furthermore, 30.4% had experienced WSS. Only 15 fellows (33%) had formal didactics on WSS during their fellowship. Most spine surgery fellows (61%, p = 0.03) were interested in a formal didactics on the prevention of WSS during their fellowship curriculum. Most (58.7%) were also interested in a Webinar on the prevention of WSS. We found of the 14 fellows that experienced WSS, 11 (79%) were significantly interested in formal didactics on WSS compared with those who had not experienced WSS (14/32, 44%; p < 0.02).

CONCLUSIONS

This is the first study evaluating spine surgery fellowship education on WSS. Among the spine surgery fellows, 30% had already experienced WSS and only 33% had formal fellowship didactics on WSS. Owing to the significant patient care and medicolegal ramifications from WSS, spine surgery fellowships should consider adding WSS prevention didactics to their curriculum.

摘要

目的

联合委员会将手术部位错误(WSS)视为警讯事件。脊柱外科住院医师关于手术部位错误的教育情况尚不清楚。我们的目的是评估北美脊柱外科住院医师关于手术部位错误的教育、认知及经历。

设计

观察性调查研究。

地点

北美脊柱外科住院医师。

参与者

在2013年4月至2013年7月以及2014年7月期间,向参与75个项目的156名脊柱外科住院医师发放了匿名问卷。收集了人口统计学信息(住院医师培训地点及住院医师培训项目的毕业后医学教育认证委员会认证情况)。我们还收集了以下数据:住院医师培训期间是否提供了关于手术部位错误的教学内容、脊柱外科住院医师的手术部位错误经历、住院医师培训期间使用的手术部位错误预防方法,以及脊柱外科住院医师是否对手术部位错误预防的教学内容或网络研讨会感兴趣。

结果

152名脊柱外科住院医师中,46名(30.3%)完成了问卷。其中,39名(84.6%)是骨科医生,7名(15.4%)是神经外科医生。大多数人在未获得毕业后医学教育认证委员会认证的项目中(70%),且在中西部(37%)、南部(30.4%)、东北部(15.2%)和西部(15.2%)接受培训。此外,30.4%的人有过手术部位错误的经历。只有15名住院医师(33%)在住院医师培训期间接受过关于手术部位错误的正规教学。大多数脊柱外科住院医师(61%,p = 0.03)对在住院医师培训课程中接受手术部位错误预防的正规教学感兴趣。大多数人(58.7%)也对手术部位错误预防的网络研讨会感兴趣。我们发现,在14名有手术部位错误经历的住院医师中,与没有手术部位错误经历的住院医师相比(14/32,44%;p < 0.02),11名(79%)对手术部位错误的正规教学有显著兴趣。

结论

这是第一项评估脊柱外科住院医师关于手术部位错误教育的研究。在脊柱外科住院医师中,30%已经有过手术部位错误的经历,只有33%接受过关于手术部位错误的正规住院医师教学。由于手术部位错误会对患者护理和法医学产生重大影响,脊柱外科住院医师培训项目应考虑在其课程中增加手术部位错误预防的教学内容。

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