Smeds Matthew R, Huynh Cindy, Thrush Carol R, Moursi Mohammed M, Amankwah Kwame S
Division of Vascular and Endovascular Surgery, Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR.
Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Division of Vascular and Endovascular Services, State University of New York - Upstate Medical University, Syracuse, NY.
Ann Vasc Surg. 2017 Oct;44:234-240. doi: 10.1016/j.avsg.2017.03.173. Epub 2017 May 11.
Mentorship within surgery, particularly vascular surgery, has not been extensively evaluated. This study sought to examine mentorship experiences in graduating vascular trainees (VTs).
An anonymous electronic survey examining current mentor relationships, ideal characteristics, academic productivity, and operative comfort level was emailed to all US graduating 2015 (n = 141) and 2016 (n = 144) VTs during their last year of training. A parallel survey was emailed to program/associate program directors (PDs) of all US vascular training programs (n = 169).
Surveys were completed by 65 (38%) PDs and 62 (22%) VTs. Forty-three (69%) VTs identified a mentor with no difference in frequency of having a mentor noted among gender, type of training (fellowship/residency), or geographical region. The majority (41/43, 95%) recognized a vascular surgeon as their mentor; the mentor was assigned to 10 of 43 (23%) trainees and was their PD to 9 of 43 (21%). Ideal mentor characteristics, identified by VTs using 4-point Likert scales, were approachability, supportiveness, and accessibility (3.94, 3.76, and 3.74, respectively), while those of a good mentee were enthusiasm, ethical work, and commitment (3.79, 3.69, and 3.45, respectively). Trainees scored accessibility, approachability, compassion, and same gender significantly higher than PDs as characteristics of ideal mentors (P < 0.05). The majority of PDs thought mentorship increased access to research opportunities, professional networking, and job opportunities, but not operative skill (90%, 95%, 65%, and 18%, respectively). There was no difference between trainees with mentors and those without in terms of reported academic productivity or operative comfort level. Vascular fellows reported higher comfort than residents in open abdominal aortic aneurysm repair (3.32 vs. 2.73, P = 0.006), juxtarenal aneurysm repair (2.8 vs. 2.1, P = 0.02), and aorto-mesenteric bypass (2.57 vs. 1.93, P = 0.03), and neither group was comfortable performing carotid stenting or fenestrated endovascular aneurysm repairs.
There is no difference in academic productivity or case comfort level between surgical trainees with mentors and those without. Possible benefits identified by PDs and trainees include professional networking and increased research and job opportunities. Mentors should be approachable, accessible, supportive, and ethical, while mentees should be enthusiastic, ethical, committed, and approachable. Vascular fellows feel more comfortable with open vascular operations than residents, and nether group feels comfortable with complex endovascular cases. More research is warranted.
外科领域，尤其是血管外科领域的导师指导作用尚未得到广泛评估。本研究旨在调查即将毕业的血管外科实习生（VTs）的导师指导经历。
在培训的最后一年，向所有2015年（n = 141）和2016年（n = 144）即将毕业的美国VTs发送了一份匿名电子调查问卷，调查内容包括当前的导师关系、理想的导师特征、学术产出以及手术舒适度。同时，向美国所有血管外科培训项目的项目/副项目主任（PDs）（n = 169）发送了一份平行调查问卷。
65名（38%）PDs和62名（22%）VTs完成了调查。43名（69%）VTs确定有导师，在性别、培训类型（专科培训/住院医师培训）或地理区域方面，有导师的频率没有差异。大多数（41/43，95%）认可血管外科医生为他们的导师；导师被分配给43名学员中的10名（23%），是他们的PD的有43名中的9名（21%）。VTs使用4分量表确定的理想导师特征是平易近人、支持性和易接近性（分别为3.94、3.76和3.74），而优秀学员的特征是热情、职业道德和敬业精神（分别为3.79、3.69和3.45）。学员们将易接近性、平易近人、同情心和同性别作为理想导师的特征，得分显著高于PDs（P < 0.05）。大多数PDs认为导师指导增加了获得研究机会、专业人脉和工作机会的可能性，但对手术技能的提升作用不大（分别为90%、95%、65%和18%）。有导师和没有导师的学员在学术产出或手术舒适度方面没有差异。血管外科专科培训学员在开放性腹主动脉瘤修复（3.32对2.73，P = 0.006）、近肾动脉瘤修复（2.8对2.1，P = 0.02）和主动脉 - 肠系膜旁路手术（2.57对1.93，P = 0.03）方面比住院医师感觉更舒适，两组在进行颈动脉支架置入术或开窗式血管内动脉瘤修复方面都不自信。
有导师和没有导师的外科实习生在学术产出或病例舒适度方面没有差异。PDs和学员确定的可能益处包括专业人脉以及增加的研究和工作机会。导师应该平易近人、易接近、支持性且有职业道德，而学员应该热情、有职业道德、敬业且平易近人。血管外科专科培训学员对开放性血管手术比住院医师感觉更舒适，两组对复杂的血管内病例都不自信。需要更多的研究。
