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手术室中培训师的正面和负面反馈如何影响外科实习医生的信心和幸福感:英格兰北部的一项定性研究

How can positive and negative trainer feedback in the operating theatre impact a surgical trainee's confidence and well-being: a qualitative study in the north of England.

作者信息

Kamali Dariush, Illing Jan

机构信息

School of Medical Education, SME Research Unit, The Medical School, Newcastle University, Newcastle upon Tyne, UK.

出版信息

BMJ Open. 2018 Feb 12;8(2):e017935. doi: 10.1136/bmjopen-2017-017935.

Abstract

OBJECTIVE

To identify the perception of positive feedback (PF) and negative feedback (NF) provided by trainers in the operating theatre on surgical trainees' confidence and well-being.

DESIGN

Narrative interview study.

SETTING

Twelve hospitals that form part of one deanery within the UK.

PARTICIPANTS

Maximum variation sampling of 15 higher general surgical trainees provided insight into how PF and NF from trainers in the operating theatre affect confidence and well-being.

METHODS

Narrative telephone interviews were conducted with general surgical trainees between April and June 2016. All interviews were recorded, transcribed and anonymised. Transcriptions were analysed using the five-step framework analysis by two independent researchers.

RESULTS

Fifteen trainees (age 28-38 years) were interviewed (median interview time: 29 min). Thematic framework analysis identified nine themes within the data. PF, which included corrective feedback, helped the trainees to relax and seemed to enhance their operative performance. All trainees reported significant and unjustified NF, some of which would be defined as undermining and bullying. Many believed this to have a negative impact on their training with minimal educational benefit. Many trainees felt NF adversely affected their performance in the operating theatre with some expressing a wish to leave the profession as a consequence.

CONCLUSION

Both PF and NF exist in the operating theatre. Both have an important influence on the trainee, their performance and career. PF, if specific, helped aid progression of learning, increased motivation and performance of surgical trainees. In contrast, NF was perceived to have detrimental effects on trainees' performance and their well-being and, in some, introduced a desire to pursue an alternative career.

摘要

目的

确定手术室培训师提供的积极反馈(PF)和消极反馈(NF)对外科实习医生信心和幸福感的影响。

设计

叙事访谈研究。

背景

英国一个教区的12家医院。

参与者

对15名普通外科高级实习医生进行最大差异抽样,以深入了解手术室培训师的PF和NF如何影响信心和幸福感。

方法

2016年4月至6月对普通外科实习医生进行叙事电话访谈。所有访谈均进行录音、转录并匿名处理。两名独立研究人员使用五步框架分析法对转录内容进行分析。

结果

对15名实习医生(年龄28 - 38岁)进行了访谈(访谈时间中位数:29分钟)。主题框架分析在数据中确定了九个主题。PF包括纠正性反馈,有助于实习医生放松,似乎还能提高他们的手术表现。所有实习医生都报告收到了严重且不合理的NF,其中一些可被定义为破坏和欺凌行为。许多人认为这对他们的培训产生了负面影响,而教育益处微乎其微。许多实习医生感到NF对他们在手术室的表现产生了不利影响,一些人因此表示希望离开这个职业。

结论

手术室中同时存在PF和NF。两者都对实习医生、他们的表现和职业有着重要影响。具体的PF有助于促进学习进程,提高外科实习医生的动力和表现。相比之下,NF被认为对实习医生的表现和幸福感有不利影响,在一些人中还引发了追求其他职业的愿望。

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