Cope Alexandra C, Mavroveli Stella, Bezemer Jeff, Hanna George B, Kneebone Roger
A.C. Cope was clinical research fellow, Imperial College London, London, United Kingdom, and senior surgical resident, Oxford Deanery, Oxford, United Kingdom, at the time this research was conducted. S. Mavroveli is a postdoctoral educational research psychologist, Imperial College London in association with the London Deanery, London, United Kingdom. J. Bezemer is senior research fellow, Institute of Education, London, United Kingdom. G.B. Hanna is professor of surgical sciences and head, Department of Surgery, Imperial College London, London, United Kingdom. R. Kneebone is professor of surgical education, Imperial College London, London, United Kingdom.
Acad Med. 2015 Aug;90(8):1125-31. doi: 10.1097/ACM.0000000000000740.
The authors aimed to map and explicate what surgeons perceive they learn in the operating room.
The researchers used a grounded theory method in which data were iteratively collected through semistructured one-to-one interviews in 2010 and 2011 at four participating hospital sites. A four-person data analysis team from differing academic backgrounds qualitatively analyzed the content of the transcripts employing an immersion/crystallization approach.
Participants were 22 UK surgeons, some of whom were in training at the time of the study and some of whom were attending surgeons. Major themes of learning in the operating room were perceived to be factual knowledge, motor skills, sensory semiosis, adaptive strategies, team working and management, and attitudes and behaviors. The analysis team classified 277 data points (short paragraphs or groups of sentences conveying meaning) under these major themes and subthemes. A key component of learning in the operating room that emerged from these data was sensory semiosis, defined as learning to make sense of visual and haptic cues.
Although the authors found that learning in the operating room occurred across a wide range of domains, sensory semiosis was found to be an important theme that has not previously been fully acknowledged or discussed in the surgical literature. The discussion draws on the wider literature from the social sciences and cognitive psychology literature to examine how professionals learn to make meaning from "signs" making parallels with other medical specialties.
作者旨在梳理并阐释外科医生认为自己在手术室中学到的内容。
研究人员采用扎根理论方法，于2010年和2011年在四个参与研究的医院站点，通过半结构化一对一访谈反复收集数据。一个由来自不同学术背景的四人组成的数据分析团队，采用沉浸/结晶法对访谈记录的内容进行定性分析。
参与者为22名英国外科医生，其中一些在研究期间仍在接受培训，另一些为在职外科医生。手术室学习的主要主题被认为是事实性知识、运动技能、感觉符号学、适应性策略、团队协作与管理以及态度和行为。分析团队将277个数据点（传达意义的短段落或句子组）归类到这些主要主题和子主题之下。从这些数据中浮现出的手术室学习的一个关键组成部分是感觉符号学，定义为学会理解视觉和触觉线索。
尽管作者发现手术室学习涵盖广泛领域，但感觉符号学是一个此前在外科文献中未得到充分承认或讨论的重要主题。讨论借鉴了社会科学和认知心理学文献中的更广泛内容，以研究专业人员如何学会从“符号”中获取意义，并与其他医学专业进行类比。
