Dune Tanaka J, Blackwell Robert H, Griffin Arianna, Taege Susanne, Sung Juliana, Mueller Elizabeth R, Brubaker Linda
From the *Department of Urology, Center for Female Pelvic Health, Weill Cornell Medicine, New York, NY; and †Department of Urology, Loyola University Medical Center; ‡Stritch School of Medicine, Loyola University Chicago; and §Departments of Obstetrics & Gynecology and Urology, Loyola University Medical Center, Maywood, Illinois.
Female Pelvic Med Reconstr Surg. 2017 Nov/Dec;23(6):401-408. doi: 10.1097/SPV.0000000000000418.
The aim of this study was to assess the perception of female pelvic medicine and reconstructive surgery (FPMRS) program directors (PDs) and obstetrics and gynecology (OG) FMPRS fellows regarding the adequacy of OG residency as preparation for FPMRS fellowship.
Electronic invitations to complete a modified version of a validated survey were extended to FPMRS PDs and their second- and third-year OG FPMRS fellows who had just completed their first or second year of FPMRS fellowship, respectively. The survey consisted of 5 domains; qualitative questions and recommendations for improvement were elicited.
Program directors (33%, 16/48) and second-year (64%, 29/45) and third-year (53%, 26/49) fellows completed the surveys. While incoming fellows were deemed professional, serious surgical skill competency issues were identified: (1) PDs felt they could not leave their incoming fellow to operate independently on a major case for 30 minutes while in the next room compared with fellow responses (PDs: 33.3% vs second-year fellows: 67.9%; P = 0.03); (2) no PDs felt their fellows could suture laparoscopically; and (3) there was group consensus that incoming fellows were not proficient at cystoscopy (PDs: 40.0%, second-year fellows: 39.3%, third-year fellows: 32.0%; P = 0.82). Mostly, fellows could clinically evaluate and manage patients. Program directors thought their fellows had better understanding of statistics than fellows believed of themselves (P = 0.05). Increasing FPMRS exposure during residency was favored as the method to better prepare OG residents for fellowship.
Quantitative and emerging qualitative outcomes highlight that fellows are professional and are largely able to evaluate and care for patients but that achieving independence, surgical skills, and scholarship requires further training.
本研究旨在评估女性盆底医学与重建外科（FPMRS）项目主任（PDs）以及妇产科（OG）FPMRS学员对OG住院医师培训作为FPMRS专科培训准备工作的充分性的看法。
向FPMRS项目主任及其刚分别完成第一年或第二年FPMRS专科培训的二年级和三年级OG FPMRS学员发出电子邀请，让他们完成一份经过修改的有效调查问卷。该调查问卷包括5个领域；还提出了定性问题及改进建议。
项目主任（33%，16/48）、二年级学员（64%，29/45）和三年级学员（53%，26/49）完成了调查。虽然新入学的学员被认为具备专业素养，但仍发现了严重的手术技能能力问题：（1）与学员的回答相比，项目主任认为他们不能让新入学的学员在隔壁房间独立进行一个大手术30分钟（项目主任：33.3%，二年级学员：67.9%；P = 0.03）；（2）没有项目主任认为他们的学员能够进行腹腔镜缝合；（3）大家一致认为新入学的学员膀胱镜检查不熟练（项目主任：40.0%，二年级学员：39.3%，三年级学员：32.0%；P = 0.82）。大多数情况下，学员能够对患者进行临床评估和管理。项目主任认为他们的学员对统计学的理解比学员自己认为的更好（P = 0.05）。增加住院医师培训期间FPMRS的接触机会被认为是让OG住院医师更好地为专科培训做准备的方法。
定量和新出现的定性结果表明，学员具备专业素养，在很大程度上能够评估和照顾患者，但要实现独立、手术技能和学术水平还需要进一步培训。
