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外科医师新技能习得策略。

Strategies for New Skill Acquisition by Practicing Surgeons.

机构信息

The University of Michigan Medical School, Ann Arbor, Michigan.

The University of Michigan Medical School, Ann Arbor, Michigan.

出版信息

J Surg Educ. 2018 Jul-Aug;75(4):928-934. doi: 10.1016/j.jsurg.2017.09.016. Epub 2017 Sep 30.

DOI:10.1016/j.jsurg.2017.09.016
PMID:28974428
Abstract

OBJECTIVE

To understand how practicing surgeons utilize available training methods, which methods are perceived as effective, and important barriers to using more effective methods.

DESIGN

Online survey designed to characterize surgeon utilization and perception of available training methods.

SETTING

Two large Midwestern academic health centers.

PARTICIPANTS

150 faculty surgeons.

METHODS

Nominal values were compared using a McNemar's Test and Likert-like values were compared using a paired t-test (IBM SPSS Statistics v. 21.0; New York, NY).

RESULTS

Survey response rate was 81% (122/150). 98% of surgeons reported learning a new procedure or technology after formal training. Many surgeons reported scrubbing in expert cases (78%) and self-directed study (66%), while few surgeons (6%) completed a mini-fellowship. The modalities used most commonly were scrubbing in expert cases (34%) and self-directed study (27%). Few surgeons (7%) believed self-directed study would be most effective, whereas 31% and 16% believed operating under supervision and mini-fellowships would be most effective, respectively. Surgeons believed more effective methods "would require too much time" or they had "confidence in their ability to implement safely."

CONCLUSIONS

Practicing surgeons use a variety of training methods when learning new procedures and technologies, and there is disconnect between commonly used training methods and those deemed most effective. Confidence in surgeon's ability was cited as a reason for this discrepancy; and surgeons found time associated with more effective methods to be prohibitive.

摘要

目的

了解外科医生如何利用现有的培训方法,哪些方法被认为是有效的,以及使用更有效的方法的重要障碍。

设计

旨在描述外科医生利用现有培训方法的情况和对这些方法的看法的在线调查。

地点

两个中西部大型学术医疗中心。

参与者

150 名外科教员。

方法

使用 McNemar 检验比较名义值,使用配对 t 检验比较类李克特值(IBM SPSS Statistics v. 21.0;纽约,NY)。

结果

调查回复率为 81%(122/150)。98%的外科医生报告在接受正式培训后学习了一项新程序或技术。许多外科医生报告在观摩专家手术(78%)和自主学习(66%)中学习,而很少有外科医生(6%)完成迷你研究员计划。最常使用的模式是观摩专家手术(34%)和自主学习(27%)。很少有外科医生(7%)认为自主学习最有效,而 31%和 16%分别认为在监督下和迷你研究员计划下操作最有效。外科医生认为更有效的方法“需要太多时间”或他们“对自己安全实施的能力有信心”。

结论

实践中的外科医生在学习新程序和技术时使用各种培训方法,但常用的培训方法与被认为最有效的方法之间存在脱节。外科医生的能力信心被认为是造成这种差异的原因;而且外科医生发现与更有效的方法相关的时间是禁止的。

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