Rashid Prem
Department of Urology, Port Macquarie Base Hospital and Rural Clinical School, University of New South Wales, Port Macquarie, NSW, Australia.
BJU Int. 2017 Mar;119(3):496-502. doi: 10.1111/bju.13731. Epub 2016 Dec 26.
To conduct a prospective, qualitative review to explore the challenges associated with the delivery of current and future high-quality urological training, and to report the reflective considerations and opinions of leaders in the Australian and New Zealand (ANZ) urological surgical training programme.
Ethics-approved semi-structured, template-based, qualitative interview techniques were used to evaluate key aspects of the current urology training programme. Those interviewed were senior office bearers and management staff involved in the Surgical Education and Training (SET) programme. Interviews were recorded and transcribed for analysis. Grounded theory was used with thematic analysis to assess the data. The initial impression given by the data was used to identify critical codes and themes, which were then developed and abstracted to bring together global concepts.
Twenty-four extracted themes were outlined. The recent evolution of urology training was documented as the pathway into training has changed several times over the years. The changes in the programme have led to concern from opinion leaders that the 'pendulum has swung too far.' Surgical teachers will only truly develop if appropriate resources are allocated. This can be achieved by making up-skilling courses accessible, relevant and, ultimately, a part of the accreditation of training posts. Management of underperforming trainees is challenging and continues to occupy a significant and disproportionate allocation of resources. Early constructive intervention is very important to avoid unnecessary escalation of complex issues and the resultant inter-personal consequences.
The ANZ SET urology programme began, like many of the other surgical specialties, from humble beginnings. It is now a mature programme, but there remain areas needing improvement. The workload of supervisors and office bearers has been increasing and the management of underperforming trainees takes time and resources away from progress in educational development. Progressive steps can be instituted to improve supervisor up-skilling, and structural changes can be made to ensure that office bearers can continue to undertake their valuable work without undue pressure and stress. Some of this will involve separating innovation in education and training from day-to-day trainee management.
进行一项前瞻性的定性研究，以探讨当前及未来高质量泌尿外科培训所面临的挑战，并报告澳大利亚和新西兰（澳新）泌尿外科手术培训项目领导者的反思性思考与观点。
采用经伦理批准的基于模板的半结构化定性访谈技术，对当前泌尿外科培训项目的关键方面进行评估。接受访谈的是参与外科教育与培训（SET）项目的高级官员和管理人员。访谈进行录音并转录以供分析。运用扎根理论和主题分析来评估数据。根据数据给出的初步印象确定关键编码和主题，然后进行拓展和提炼，以整合全局概念。
共概述了24个提炼出的主题。记录了泌尿外科培训的近期演变情况，因为多年来进入培训的途径发生了多次变化。培训项目的这些变化引发了意见领袖的担忧，即“钟摆摆动得太远了”。只有分配适当的资源，外科教师才能真正得到发展。这可以通过使技能提升课程易于获取、具有相关性，并最终成为培训岗位认证的一部分来实现。对表现不佳的学员进行管理具有挑战性，并且继续占用大量且不成比例的资源分配。早期的建设性干预对于避免复杂问题不必要的升级以及由此产生的人际后果非常重要。
澳新SET泌尿外科项目与许多其他外科专科一样，起步时规模较小。它现在是一个成熟的项目，但仍有需要改进的领域。主管人员和官员的工作量一直在增加，而对表现不佳的学员进行管理耗费时间和资源，影响了教育发展的进程。可以采取渐进措施来提高主管人员的技能，进行结构调整以确保官员能够在没有过度压力和紧张的情况下继续开展他们的重要工作。其中一些措施将涉及将教育培训方面的创新与日常学员管理分开。
