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评估住院医师和教职员工参与全球外科手术的兴趣及障碍。

Assessing Interest and Barriers for Resident and Faculty Involvement in Global Surgery.

作者信息

Cheung Maija, Healy James M, Hall Michael R, Ozgediz Doruk

机构信息

Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.

Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.

出版信息

J Surg Educ. 2018 Jan-Feb;75(1):49-57. doi: 10.1016/j.jsurg.2017.06.031. Epub 2017 Jul 17.

Abstract

BACKGROUND

Multiple institutions have developed international electives and sustainable global surgery initiatives to facilitate clinical, research, and outreach opportunities with hospitals in resource-poor areas. Despite increasing interest among programs, many institutions have not successfully reached potential involvement.

OBJECTIVE

This study evaluates the experiences of Yale residents and faculty, measures interest in the development of an international surgical elective, and enumerates barriers to developing or participating in these opportunities. This was performed to develop a formalized elective and assess interest and capacity for surgical global health initiatives, as a seemingly increasing number of trainee applicants and residents were expressing interest in working in resource-poor settings.

METHODS

Electronic survey of Yale Surgery residents and faculty analyzed using SPSS and Graphpad Prism.

RESULTS

Among residents, previous global experience correlates with current interest in international opportunities, with 100% remaining interested, and 78% of those without prior experience also expressing interest (p = 0.018). Barriers to pursuing these activities included the use of vacation time, funding, scheduling, family obligations, and concern for personal safety. Among faculty, 28% of respondents have been involved internationally, and most (86%) expressed interest in additional opportunities and all were willing to take residents. Barriers to faculty participation included funding, relative value unit target reduction, protected time, and the desire for institutional support for such activities.

CONCLUSIONS

A substantial proportion of residents and faculty have experience in global health and motivation to pursue additional opportunities. The main barriers to participation are not a lack of interest, but rather needs for funding support, protected time, and institutional recognition of academic contributions. These findings are being used to develop a global surgery elective and establish long-term partnerships with international colleagues.

摘要

背景

多个机构已开展国际选修课程及可持续全球外科项目,以促进与资源匮乏地区医院的临床、研究及外展合作机会。尽管各项目的兴趣日益浓厚,但许多机构尚未成功实现潜在参与度。

目的

本研究评估耶鲁大学住院医师和教职员工的经历,衡量对开展国际外科选修课程的兴趣,并列举开展或参与这些机会的障碍。开展此项研究是为了制定一项正式的选修课程,并评估外科全球健康项目的兴趣和能力,因为越来越多的实习申请人和住院医师表示有兴趣在资源匮乏地区工作。

方法

使用SPSS和Graphpad Prism对耶鲁大学外科住院医师和教职员工进行电子调查。

结果

在住院医师中,以往的全球经历与当前对国际机会的兴趣相关,有全球经历的住院医师100%仍感兴趣,而78%没有先前经历的住院医师也表示有兴趣(p = 0.018)。开展这些活动的障碍包括使用休假时间、资金、日程安排、家庭义务以及对个人安全的担忧。在教职员工中,28%的受访者有国际工作经历,大多数(86%)表示对更多机会感兴趣,并且所有人都愿意带住院医师。教职员工参与的障碍包括资金、相对价值单位目标降低、受保护时间以及希望机构支持此类活动。

结论

相当一部分住院医师和教职员工有全球健康方面的经验并有追求更多机会的动力。参与的主要障碍并非缺乏兴趣,而是需要资金支持、受保护时间以及机构对学术贡献的认可。这些研究结果正被用于制定全球外科选修课程,并与国际同行建立长期合作关系。

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