Department of Surgery, University of Toronto, Toronto, Canada.
Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.
Br J Surg. 2016 May;103(6):763-771. doi: 10.1002/bjs.10103. Epub 2016 Mar 23.
Surgical education is becoming competency-based with the implementation of in-training milestones. Training guidelines should reflect these changes and determine the specific procedures for such milestone assessments. This study aimed to develop a consensus view regarding operative procedures and tasks considered appropriate for junior and senior trainees, and the procedures that can be used as technical milestone assessments for trainee progression in general surgery.
A Delphi process was followed where questionnaires were distributed to all 17 Canadian general surgery programme directors. Items were ranked on a 5-point Likert scale, with consensus defined as Cronbach's α of at least 0·70. Items rated 4 or above on the 5-point Likert scale by 80 per cent of the programme directors were included in the models.
Two Delphi rounds were completed, with 14 programme directors taking part in round one and 11 in round two. The overall consensus was high (Cronbach's α = 0·98). The training model included 101 unique procedures and tasks, 24 specific to junior trainees, 68 specific to senior trainees, and nine appropriate to all. The assessment model included four procedures.
A system of operative procedures and tasks for junior- and senior-level trainees has been developed along with an assessment model for trainee progression. These can be used as milestones in competency-based assessments.
随着培训中里程碑的实施，外科教育正变得以能力为基础。培训指南应反映这些变化，并确定对这些里程碑评估的具体程序。本研究旨在就初级和高级受训者认为合适的手术程序和任务以及可作为普通外科培训生技术里程碑评估的程序达成共识。
采用德尔菲法，向所有 17 位加拿大普通外科项目主任分发问卷。项目按 5 分李克特量表进行评分，共识定义为 Cronbach's α至少为 0·70。80%的项目主任对 5 分李克特量表的评分在 4 分或以上的项目纳入模型。
完成了两轮德尔菲法，第一轮有 14 位项目主任参加，第二轮有 11 位。总体共识度较高（Cronbach's α=0·98）。培训模型包括 101 个独特的程序和任务，其中 24 个专门针对初级受训者，68 个专门针对高级受训者，9 个适合所有受训者。评估模型包括四个程序。
已经制定了针对初级和高级受训者的手术程序和任务系统，以及培训生进展的评估模型。这些可以用作基于能力的评估中的里程碑。
