Dai Julia, Bordeaux Jeremy S, Miller Christopher J, Sobanko Joseph F
*Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; †Department of Dermatology, Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, Ohio; ‡Division of Dermatologic Surgery and Cutaneous Oncology, Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Dermatol Surg. 2016 Aug;42(8):977-84. doi: 10.1097/DSS.0000000000000802.
Resident surgical education and technical skills may be enhanced with deliberate practice-based learning. Deliberate practice methods, such as simulation-based training and formal skills-based assessments, allow for trainees to repeatedly practice a defined task with expert supervision and feedback.
The authors sought to characterize how surgical skills are taught and assessed in dermatology residency, with an emphasis on whether deliberate practice methods are incorporated in the surgical curriculum.
A survey was administered to program directors at 117 Accreditation Council for Graduate Medical Education-approved dermatology residency programs during 2013 to 2014.
A total of 42 responses (36%) were collected. Over half of programs (57%) devote 10 to 30 hours each year to surgical didactics. Sixty-nine percent of programs use simulation models, and 62% of programs use formal assessment-guided feedback in evaluating surgical skills. Residents most commonly assume the role of primary surgeon in excisional surgery (100%) and less commonly in graft and flap reconstruction (52% and 52%, respectively). Twenty-nine percent of residents are the primary surgeons in Mohs micrographic surgery.
Dermatology residency programs are incorporating deliberate practice-based tenets in the surgical curriculum. These results provide a benchmark for programs to assess and improve the quality of dermatologic surgery training.
基于刻意练习的学习可以提升住院医师的外科教育水平和技术技能。刻意练习方法，如基于模拟的训练和基于正式技能的评估，能让学员在专家监督和反馈下反复练习特定任务。
作者试图描述皮肤科住院医师培训中外科技能的教学和评估方式，重点是外科课程中是否纳入了刻意练习方法。
2013年至2014年期间，对117个经研究生医学教育认证委员会批准的皮肤科住院医师培训项目的项目主任进行了一项调查。
共收集到42份回复（36%）。超过半数的项目（57%）每年投入10至30小时进行外科教学。69%的项目使用模拟模型，62%的项目在评估外科技能时使用基于正式评估的反馈。住院医师在切除手术中最常担任主刀医生（100%），而在移植和皮瓣重建手术中担任主刀医生的比例较低（分别为52%和52%）。29%的住院医师在莫氏显微外科手术中担任主刀医生。
皮肤科住院医师培训项目正在将基于刻意练习的原则纳入外科课程。这些结果为各项目评估和提高皮肤科手术培训质量提供了一个基准。
