Dean Ben, Jones Luke, Garfjeld Roberts Patrick, Rees Jonathan
Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, United Kingdom.
Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, United Kingdom.
J Surg Educ. 2017 Sep-Oct;74(5):843-850. doi: 10.1016/j.jsurg.2017.01.010. Epub 2017 Apr 6.
Surgical training has been subject to significant upheaval in recent years with an increasingly rigorous assessment regimen for trainees. The assessment of surgical trainers is less well evolved by comparison. Recent proposals from the Royal College of Surgeons of England recommend "professionalising the trainers." However, they do not suggest any accepted or validated methods of trainer assessment, nor do they indicate how these might be implemented and monitored in a real-world training program to determine their effect on trainee outcomes.
To determine what is known about the attributes of successful surgical trainers.
We conducted a systematic review of the scientific literature using the preferred reporting items for systematic reviews and meta-analyses and Cochrane guidelines of the Medline database using specific search criteria. The qualitative analysis involved grouping trainer attributes together into "themes" within 4 "super-themes." Each theme needed to be mentioned by a minimum of 5 studies.
After review of the full study texts a total of 14 studies met the inclusion criteria. Thirteen studies involved the views of trainees, whereas only 1 study solely assessed the views of trainers. There was a wide variety of study designs and types of participants. The attribute themes are listed in brackets after each super-theme: "character" (approachability, patience, enthusiasm, encouraging/supportiveness), "procedural" (willingness to let trainee operate, balance between supervision and independence), "teamwork and communication" (sets educational aims and objectives, ability to use appropriate feedback, communication skills, and time availability to train) and "clinical" (capable, good relationships with patients, and the health care team).
This detailed review describes several perceived important themes for the positive attributes of surgical trainers. The identification of these key attributes is only of value if their presence is confirmed by effective and feasible evaluation, and if the possession of such attributes in trainers is proven to have a positive effect on training. In times of reduced training opportunities, exploring the topics raised by this review through future education research is warranted.
近年来，外科培训经历了重大变革，对学员的评估制度日益严格。相比之下，对外科培训师的评估发展得不够完善。英国皇家外科医学院最近的提议建议“使培训师专业化”。然而，他们没有提出任何被认可或经过验证的培训师评估方法，也没有说明如何在实际培训项目中实施和监测这些方法，以确定它们对学员成果的影响。
确定关于成功的外科培训师的特质的已知信息。
我们使用系统评价和Meta分析的首选报告项目以及Cochrane指南，对Medline数据库进行系统检索，采用特定的检索标准。定性分析涉及将培训师特质分组为4个“超级主题”中的“主题”。每个主题至少需要5项研究提及。
在审查完整的研究文本后，共有14项研究符合纳入标准。13项研究涉及学员的观点，而只有1项研究仅评估了培训师的观点。研究设计和参与者类型多种多样。每个超级主题后的括号内列出了特质主题：“性格”（平易近人、耐心、热情、鼓励/支持）、“程序”（愿意让学员操作、监督与独立之间的平衡）、“团队合作与沟通”（设定教育目标、使用适当反馈的能力、沟通技巧以及培训时间的可用性）和“临床”（能力强、与患者和医疗团队关系良好）。
这项详细的综述描述了外科培训师积极特质的几个重要主题。只有通过有效且可行的评估确认这些关键特质的存在，并且证明培训师具备这些特质对培训有积极影响，这些特质的识别才有价值。在培训机会减少的时期，通过未来的教育研究探索本综述提出的主题是有必要的。
