Pritzker School of Medicine, The University of Chicago, Chicago, Illinois.
Department of Orthopaedic Surgery and Rehabilitation Medicine, The University of Chicago, Chicago, Illinois.
J Surg Educ. 2017 Nov-Dec;74(6):1001-1006. doi: 10.1016/j.jsurg.2017.05.014. Epub 2017 Jun 12.
To measure patient and family member comfort with surgical trainees of varying levels performing different portions of surgery.
DESIGN, SETTING, AND PARTICIPANTS: An electronic survey dividing surgery into 6 steps (prepping and positioning, initial incision, deep dissection, critical portions, deep suturing, and closing incision), differentiating surgical trainees by 4 levels of experience (medical student, intern, resident, and fellow), and specifying whether or not an attending surgeon is in the operating room (OR) was given to 200 patients and family members in the surgical waiting area of a single academic medical center. Responses were on a 7-point Likert scale from "Not Comfortable at All" to "Completely Comfortable".
Patient and family member comfort significantly increased as trainee experience increased. It reached a nadir for all trainees performing "critical portions" of surgery. However, their average response was "Comfortable" for residents and fellows performing any surgical step when the attending surgeon is present in the OR. The percentage of "Comfortable" responses was significantly lower for all trainee levels performing any surgical step when the attending surgeon is absent from the OR.
Patient and family member comfort with surgical trainees operating varies based on the trainee's level of experience, the step the trainee performs, and whether or not the attending surgeon is present in the OR. Patients and family members are on average "Comfortable" with surgical residents and fellows performing any surgical step when the attending surgeon is present.
衡量患者和家属对不同水平的外科受训者进行不同手术部分的舒适度。
设计、环境和参与者:一项电子调查将手术分为 6 个步骤(准备和定位、初始切口、深部解剖、关键部位、深部缝合和切口关闭),根据经验水平将外科受训者分为 4 个等级(医学生、实习生、住院医师和研究员),并指定是否有主治医生在手术室(OR)。该调查在一家学术医疗中心的外科等候区向 200 名患者和家属发放。回答采用 7 分李克特量表,从“完全不舒服”到“完全舒服”。
随着受训者经验的增加,患者和家属的舒适度显著提高。当所有受训者进行“关键部位”手术时,舒适度达到最低点。然而,当主治医生在 OR 时,住院医师和研究员进行任何手术步骤的平均反应都是“舒服”。当主治医生不在 OR 时,所有受训者在进行任何手术步骤时,“舒服”的比例都显著降低。
患者和家属对手术受训者操作的舒适度取决于受训者的经验水平、受训者执行的手术步骤以及主治医生是否在 OR 中。当主治医生在场时,患者和家属平均对住院医师和研究员进行任何手术步骤感到“舒服”。