视频辅导作为外科住院医师的一种高效教学方法——一项随机对照试验
Video Coaching as an Efficient Teaching Method for Surgical Residents-A Randomized Controlled Trial.
作者信息
Soucisse Mikael L, Boulva Kerianne, Sideris Lucas, Drolet Pierre, Morin Michel, Dubé Pierre
机构信息
Department of Surgery, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Québec, Canada.
Department of Surgery, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montréal, Québec, Canada.
出版信息
J Surg Educ. 2017 Mar-Apr;74(2):365-371. doi: 10.1016/j.jsurg.2016.09.002. Epub 2016 Oct 5.
BACKGROUND
As surgical training is evolving and operative exposure is decreasing, new, effective, and experiential learning methods are needed to ensure surgical competency and patient safety. Video coaching is an emerging concept in surgery that needs further investigation.
DESIGN
In this randomized controlled trial conducted at a single teaching hospital, participating residents were filmed performing a side-to-side intestinal anastomosis on cadaveric dog bowel for baseline assessment. The Surgical Video Coaching (SVC) group then participated in a one-on-one video playback coaching and debriefing session with a surgeon, during which constructive feedback was given. The control group went on with their normal clinical duties without coaching or debriefing. All participants were filmed making a second intestinal anastomosis. This was compared to their first anastomosis using a 7-category-validated technical skill global rating scale, the Objective Structured Assessment of Technical Skills. A single independent surgeon who did not participate in coaching or debriefing to the SVC group reviewed all videos. A satisfaction survey was then sent to the residents in the coaching group.
SETTING
Department of Surgery, HôpitalMaisonneuve-Rosemont, tertiary teaching hospital affiliated to the University of Montreal, Canada.
PARTICIPANTS
General surgery residents from University of Montreal were recruited to take part in this trial. A total of 28 residents were randomized and completed the study.
RESULTS
After intervention, the SVC group (n = 14) significantly increased their Objective Structured Assessment of Technical Skills score (mean of differences 3.36, [1.09-5.63], p = 0.007) when compared to the control group (n = 14) (mean of differences 0.29, p = 0.759). All residents agreed or strongly agreed that video coaching was a time-efficient teaching method.
CONCLUSIONS
Video coaching is an effective and efficient teaching intervention to improve surgical residents' technical skills.
背景
随着外科手术培训的不断发展以及手术暴露范围的减小,需要新的、有效的和体验式学习方法来确保手术能力和患者安全。视频指导是外科领域中一个新兴的概念,需要进一步研究。
设计
在一家教学医院进行的这项随机对照试验中,对参与的住院医师在尸体犬肠管上进行侧侧肠吻合术的过程进行拍摄,作为基线评估。然后,手术视频指导(SVC)组与一名外科医生参加一对一的视频回放指导和总结会议,期间提供建设性反馈。对照组继续其正常临床工作,不接受指导或总结。所有参与者再次进行肠吻合术并被拍摄。使用经过7级验证的技术技能整体评分量表(客观结构化技术技能评估)将此次吻合与他们的首次吻合进行比较。由一名未参与SVC组指导或总结的独立外科医生审查所有视频。随后向指导组的住院医师发送满意度调查问卷。
地点
加拿大蒙特利尔大学附属的三级教学医院——蒙特利尔玫瑰圣母医院外科。
参与者
招募了蒙特利尔大学普通外科住院医师参与本试验。共有28名住院医师被随机分组并完成了研究。
结果
干预后,与对照组(n = 14)相比,SVC组(n = 14)的客观结构化技术技能评估得分显著提高(差异均值为3.36,[1.09 - 5.63],p = 0.007),而对照组差异均值为0.29,p = 0.759。所有住院医师都同意或强烈同意视频指导是一种省时的教学方法。
结论
视频指导是一种有效且高效的教学干预手段,可提高外科住院医师的技术技能。