Jones Grace F, Forsyth Katherine, Jenewein Caitlin G, Ray Rebecca D, DiMarco Shannon, Pugh Carla M
University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA.
University of Wisconsin-Madison, School of Medicine and Public Health, Department of Surgery, 600 Highland Avenue, Clinical Science Center, K6/100, Madison, WI, 53792, USA; University of Wisconsin-Madison, School of Engineering, Department of Industrial and Systems Engineering, 3214 Mechanical Engineering Building, 1513 University Avenue, Madison, WI, 53706, USA.
Am J Surg. 2017 Apr;213(4):631-636. doi: 10.1016/j.amjsurg.2016.12.003. Epub 2016 Dec 11.
Skills decay is a known risk for surgical residents who have dedicated research time. We hypothesize that simulation-based assessments will reveal significant differences in perceived skill decay when assessing a variety of clinical scenarios in a longitudinal fashion.
Residents (N = 46; Returning: n = 16, New: n = 30) completed four simulated procedures: urinary catheterization, central line, bowel anastomosis, and laparoscopic ventral hernia repair. Perception surveys were administered pre- and post-simulation.
Perceptions of skill decay and task difficulty were similar for both groups across three procedures pre- and post-simulation. Due to a simulation modification, new residents were more confident in urinary catheterization than returning residents (F(1,4) = 11.44, p = 0.002). In addition, when assessing expectations for skill reduction, returning residents perceived greater skill reduction upon reassessment when compared to first time residents (t(35) = 2.37, p = 0.023).
Research residents may benefit from longitudinal skills assessments and a wider variety of simulation scenarios during their research years. TABLE OF CONTENTS SUMMARY: As part of a longitudinal study, we assessed research residents' confidence, perceptions of task difficulty and surgical skill reduction. Residents completed surveys pre- and post-experience with four simulated procedures: urinary catheterization, subclavian central line insertion, bowel anastomosis, and laparoscopic ventral hernia repair. Returning residents perceived greater skill reduction upon reassessment when compared to residents participating for the first time. In addition, modification of the clinical scenarios affected perceptions of skills decay.
技能衰退是从事研究工作的外科住院医师面临的一个已知风险。我们假设,基于模拟的评估在纵向评估各种临床场景时,将揭示出感知技能衰退方面的显著差异。
住院医师(N = 46;返回者:n = 16,新住院医师:n = 30)完成了四项模拟操作:导尿、中心静脉置管、肠吻合和腹腔镜腹疝修补术。在模拟前后进行了认知调查。
在模拟前后的三项操作中,两组对技能衰退和任务难度的认知相似。由于模拟的修改,新住院医师在导尿方面比返回的住院医师更有信心(F(1,4) = 11.44,p = 0.002)。此外,在评估技能下降的预期时,与首次住院医师相比,返回的住院医师在重新评估时认为技能下降更大(t(35) = 2.37,p = 0.023)。
研究住院医师在其研究期间可能会从纵向技能评估和更多样化的模拟场景中受益。目录摘要:作为一项纵向研究的一部分,我们评估了研究住院医师的信心、对任务难度的认知以及手术技能下降情况。住院医师在经历四项模拟操作(导尿、锁骨下中心静脉置管、肠吻合和腹腔镜腹疝修补术)前后完成了调查。与首次参与的住院医师相比,返回的住院医师在重新评估时认为技能下降更大。此外,临床场景的修改影响了对技能衰退的认知。