Hoffmann Henry, Oertli Daniel, Mechera Robert, Dell-Kuster Salome, Rosenthal Rachel, Reznick Richard, MacDonald Hugh
Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland.
Department of General and Visceral Surgery, University Hospital Basel, Basel, Switzerland.
J Surg Educ. 2017 Jan-Feb;74(1):37-46. doi: 10.1016/j.jsurg.2016.07.013. Epub 2016 Sep 30.
Quality of surgical training in the era of resident duty-hour restrictions (RDHR) is part of an ongoing debate. Most training elements are provided during surgical service. As exposure to surgical procedures is important but time-consuming, RDHR may affect quality of surgical training. Providing structured training elements may help to compensate for this shortcoming.
This binational anonymous questionnaire-based study evaluates frequency, time, and structure of surgical training programs at 2 typical academic teaching hospitals with different RDHR.
Departments of Surgery of University of Basel (Basel, Switzerland) and the Queen's University (Kingston, Ontario, Canada).
Surgical consultants and residents of the Queen's University Hospital (Kingston, Ontario, Canada) and the University Hospital Basel (Basel, Switzerland) were eligible for this study.
Questionnaire response rate was 37% (105/284). Queen's residents work 80 hours per week, receiving 7 hours of formal training (8.8% of workweek). Basel residents work 60 hours per week, including 1 hour of formal training (1.7% of working time). Queen's faculty and residents rated their program as "structured" or "rather structured" in contrast to Basel faculty and residents who rated their programs as "neutral" in structure or "unstructured." Respondents identified specific structured training elements more frequently at Queen's than in Basel. Two-thirds of residents responded that they seek out additional surgical experiences through voluntary extra work. Basel participants articulated a stronger need for improvement of current surgical training. Although Basel residents and consultants in both institutions fear negative influence of RDHR on the training program, this was not the case in Queen's residents.
Providing more structured surgical training elements may be advantageous in providing optimal-quality surgical education in an era of work-hour restrictions.
住院医师值班时间限制（RDHR）时代的外科培训质量是一个持续争论的话题。大多数培训内容是在外科服务期间提供的。由于接触外科手术很重要但耗时，RDHR可能会影响外科培训质量。提供结构化的培训内容可能有助于弥补这一缺陷。
这项基于双国匿名问卷调查的研究评估了两家具有不同RDHR的典型学术教学医院外科培训项目的频率、时间和结构。
巴塞尔大学（瑞士巴塞尔）和皇后大学（加拿大安大略省金斯顿）的外科系。
皇后大学医院（加拿大安大略省金斯顿）和巴塞尔大学医院（瑞士巴塞尔）的外科顾问和住院医师符合本研究条件。
问卷回复率为37%（105/284）。皇后大学的住院医师每周工作80小时，接受7小时的正规培训（占工作周的8.8%）。巴塞尔的住院医师每周工作60小时，包括1小时的正规培训（占工作时间的1.7%）。皇后大学的教员和住院医师将他们的培训项目评为“结构化”或“比较结构化”，而巴塞尔的教员和住院医师则将他们的项目评为结构“中性”或“非结构化”。与巴塞尔相比，受访者在皇后大学更频繁地指出特定的结构化培训内容。三分之二的住院医师表示，他们通过自愿加班来寻求额外的外科手术经验。巴塞尔的参与者明确表示更需要改进当前的外科培训。尽管两所机构的巴塞尔住院医师和顾问都担心RDHR对培训项目有负面影响，但皇后大学的住院医师并非如此。
在工作时间受限的时代，提供更多结构化的外科培训内容可能有利于提供高质量的外科教育。
