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发展中国家的外科教育联合方法:教育需求评估。

A Consortium Approach to Surgical Education in a Developing Country: Educational Needs Assessment.

机构信息

Department of Surgery, Oregon Health & Science University, Portland.

Department of Surgery, University of California, San Francisco.

出版信息

JAMA Surg. 2015 Nov;150(11):1074-8. doi: 10.1001/jamasurg.2015.2205.

Abstract

IMPORTANCE

Surgical disease is a global health priority, and improving surgical care requires local capacity building. Single-institution partnerships and surgical missions are logistically limited. The Alliance for Global Clinical Training (hereafter the Alliance) is a consortium of US surgical departments that aims to provide continuous educational support at the Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania (MUHAS). To our knowledge, the Alliance is the first multi-institutional international surgical collaboration to be described in the literature.

OBJECTIVE

To assess if the Alliance is effectively responding to the educational needs of MUHAS and Muhimbili National Hospital surgeons.

DESIGN, SETTING, AND PARTICIPANTS: During an initial 13-month program (July 1, 2013, to August 31, 2014), faculty and resident teams from 3 US academic surgical programs rotated at MUHAS as physicians and teachers for 1 month each. To assess the value of the project, we administered anonymous surveys.

MAIN OUTCOMES AND MEASURES

Anonymous surveys were analyzed on a 5-point Likert-type scale. Free-text answers were analyzed for common themes.

RESULTS

During the study period, Alliance members were present at MUHAS for 8 months (1 month each). At the conclusion of the first year of collaboration, 15 MUHAS faculty and 22 MUHAS residents completed the survey. The following 6 areas of educational needs were identified: formal didactics, increased clinical mentorship, longer-term Alliance presence, equitable distribution of teaching time, improved coordination and language skills, and reciprocal exchange rotations at US hospitals. The MUHAS faculty and residents agreed that Alliance members contributed to improved patient care and resident education.

CONCLUSIONS AND RELEVANCE

A multi-institutional international surgical partnership is possible and leads to perceived improvements in patient care and resident learning. Alliance surgeons must continue to focus on training Tanzanian surgeons. Improving the volunteer surgeons' Swahili-language skills would be an asset. Future efforts should provide more teaching coverage, equitably distribute educational support among all MUHAS surgeons, and collaboratively develop a formal surgical curriculum.

摘要

重要性

外科疾病是全球卫生重点,而提高外科护理水平需要建立当地能力。单一机构的伙伴关系和外科任务在后勤上受到限制。全球临床培训联盟(以下简称联盟)是一个由美国外科部门组成的联盟,旨在为坦桑尼亚达累斯萨拉姆穆希比利大学健康与联合科学大学(MUHAS)提供持续的教育支持。据我们所知,该联盟是文献中描述的第一个多机构国际外科合作组织。

目的

评估联盟是否有效地满足 MUHAS 和穆希比利国家医院外科医生的教育需求。

设计、地点和参与者:在最初的 13 个月计划(2013 年 7 月 1 日至 2014 年 8 月 31 日)期间,来自 3 个美国学术外科项目的教员和住院医师团队轮流在 MUHAS 担任医生和教师,每个月 1 个月。为了评估项目的价值,我们进行了匿名调查。

主要结果和措施

对匿名调查进行了 5 点李克特量表分析。对自由文本答案进行了主题分析。

结果

在研究期间,联盟成员在 MUHAS 停留了 8 个月(每个月 1 个月)。在合作的第一年结束时,15 名 MUHAS 教师和 22 名 MUHAS 居民完成了调查。确定了以下 6 个教育需求领域:正规教学、增加临床指导、长期联盟存在、公平分配教学时间、改善协调和语言技能以及在美国医院进行互惠交流轮转。MUHAS 的教师和居民一致认为,联盟成员有助于改善患者护理和住院医师教育。

结论和相关性

多机构国际外科伙伴关系是可能的,并导致患者护理和住院医师学习的感知改善。联盟外科医生必须继续专注于培训坦桑尼亚外科医生。提高志愿外科医生的斯瓦希里语技能将是一项资产。未来的努力应提供更多的教学覆盖范围,在所有 MUHAS 外科医生之间公平分配教育支持,并合作制定正式的外科课程。

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