Department of Surgery, New York University School of Medicine, New York, NY.
Ann Surg. 2016 Sep;264(3):501-7. doi: 10.1097/SLA.0000000000001843.
Professionalism education is a vital component of surgical training. This research attempts to determine whether an annual, year-long professionalism curriculum in a large surgical residency can effectively change professionalism attitudes.
The ACGME mandated 6 competencies in 2003. The competencies of Professionalism and Interpersonal/Professional Communication Skills had never been formally addressed in surgical resident education in the past.
A professionalism curriculum was developed focusing on specific resident professionalism challenges: admitting mistakes, effective communication with colleagues at all levels, delivering the news of an unexpected death, interdisciplinary challenges of working as a team, the cultural challenge of obtaining informed consent through an interpreter, and the stress of surgical practice on you and your family. These professionalism skills were then evaluated with a 6-station Objective Structured Clinical Examination (OSCE). Identical OSCE scenarios were administered to 2 cohorts of surgical residents: in 2007 (before instituting the professionalism curriculum in 2008) and again in 2014. Surgical residents were rated by trained Standardized Patients according to a behaviorally anchored professionalism criteria checklist.
An analysis of variance was conducted of overall OSCE professionalism scores (% well done) as the dependent variable for the 2 resident cohorts (2007 vs 2014). The 2007 residents received a mean score of 38% of professionalism items "well done" (SD 9%) and the 2014 residents received a mean 59% "well done" (SD 8%). This difference is significant (F = 49.01, P < .001).
Professionalism education has improved surgical resident understanding, awareness, and practice of professionalism in a statistically significant manner from 2007 to 2014. This documented improvement in OSCE performance reflects the value of a professionalism curriculum in the care of the patients we seek to serve.
专业精神教育是外科培训的重要组成部分。本研究试图确定在大型外科住院医师培训中，每年进行为期一年的专业精神课程是否能有效改变专业精神态度。
ACGME 在 2003 年规定了 6 项能力。过去，在外科住院医师教育中，从未正式涉及专业精神和人际/专业沟通技巧这两个能力。
制定了一个专业精神课程，重点关注特定的住院医师专业精神挑战：承认错误、与各级同事进行有效沟通、传达意外死亡的消息、作为团队工作的跨学科挑战、通过翻译获得知情同意的文化挑战，以及手术实践对你和你的家庭的压力。然后使用 6 站客观结构化临床考试（OSCE）来评估这些专业精神技能。对 2 批外科住院医师进行了相同的 OSCE 情景模拟：2007 年（在 2008 年实施专业精神课程之前）和 2014 年。经过培训的标准化患者根据行为锚定的专业精神标准检查表对住院医师进行评分。
对 2 个住院医师组（2007 年与 2014 年）的整体 OSCE 专业精神评分（%完成良好）作为因变量进行方差分析。2007 年的住院医师在专业精神项目中获得了 38%的“完成良好”评分（标准差为 9%），而 2014 年的住院医师获得了 59%的“完成良好”评分（标准差为 8%）。这一差异具有统计学意义（F = 49.01，P<0.001）。
从 2007 年到 2014 年，专业精神教育以统计学上显著的方式提高了外科住院医师对专业精神的理解、意识和实践。OSCE 表现的这种有记录的改善反映了在我们试图服务的患者护理中专业精神课程的价值。
