Zender Chad A, Clancy Kate, Melki Sami, Li Shawn, Fowler Nicole
Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, U.S.A.
Case Western Reserve School of Medicine, Cleveland, Ohio, U.S.A.
Laryngoscope. 2018 Jan;128(1):52-56. doi: 10.1002/lary.26680. Epub 2017 Jun 11.
To assess the impact of a microvascular head and neck (H&N) fellowship on senior residents' surgical experience.
Retrospective review of Accreditation Council for Graduate Medical Education-generated operative case log reports, retrospective chart review, and electronic survey.
A retrospective review of one institution's residents' H&N operative case logs and free flap operative reports was performed to determine changes in key indicator cases (KICs) after the addition of a H&N fellowship. An electronic survey was distributed to senior residents at all U.S. otolaryngology residency programs to determine residents' perceptions of a H&N fellow's impact on their surgical experience. An electronic survey was distributed to senior medical students applying to surgical residencies to explore the perceived impact that a fellowship has on the desirability of a residency program.
The average number of each postgraduate year (PGY)5's H&N KIC before and after the addition of the fellowship were: parotidectomy, 19 versus 17.8; neck dissection, 33.2 versus 40.6; oral cavity resection, 15.3 versus 12.6; thyroid/parathyroid, 45.5 versus 45.6; and flaps/grafts, 56.7 versus 42. PGY5 participation as first assistant in free flaps dropped from 78% to 17%; however, residents still participated in some aspect of 45% of the cases. Seventy percent of senior residents reported a positive perception of the H&N fellow on their H&N operative experience. Eighty-nine percent of senior medical student respondents reported a nonnegative perception of a fellowship in their applied field.
The addition of a H&N fellowship did not decrease senior residents' H&N KIC, and most senior residents at programs with fellowships report that the fellow has a positive impact on their H&N operative experience.
评估微血管头颈（H&N）专科培训对高级住院医师手术经验的影响。
对研究生医学教育认证委员会生成的手术病例日志报告进行回顾性审查、回顾性病历审查和电子调查。
对一家机构的住院医师的头颈手术病例日志和游离皮瓣手术报告进行回顾性审查，以确定增加头颈专科培训后关键指标病例（KICs）的变化。向美国所有耳鼻喉科住院医师培训项目的高级住院医师发放电子调查问卷，以确定住院医师对头颈专科培训学员对其手术经验影响的看法。向申请外科住院医师培训的高年级医学生发放电子调查问卷，以探讨专科培训对住院医师培训项目吸引力的感知影响。
增加专科培训前后，各研究生第5年（PGY）5的头颈KIC平均数量分别为：腮腺切除术，19例对17.8例；颈部清扫术，33.2例对40.6例；口腔切除术，15.3例对12.6例；甲状腺/甲状旁腺手术，45.5例对45.6例；皮瓣/移植手术，56.7例对42例。PGY5作为游离皮瓣第一助手的参与率从78%降至17%；然而，住院医师仍参与了45%病例的某些方面。70%的高级住院医师对头颈专科培训学员的头颈手术经验给予了积极评价。89%的高年级医学生受访者对其申请领域的专科培训给予了非负面评价。
增加头颈专科培训并未减少高级住院医师的头颈KIC，大多数有专科培训学员的项目中的高级住院医师报告称，该学员对头颈手术经验有积极影响。
4。《喉镜》，2018年，第128卷，第52 - 56页。
