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理解外科住院医师和研究员对其手术表现反馈需求的观点:一项定性研究。

Understanding Surgical Resident and Fellow Perspectives on Their Operative Performance Feedback Needs: A Qualitative Study.

机构信息

Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Surgery, Inova Fairfax Medical Campus; Falls Church, Virginia.

出版信息

J Surg Educ. 2018 Nov;75(6):1498-1503. doi: 10.1016/j.jsurg.2018.04.002. Epub 2018 Apr 22.

Abstract

OBJECTIVE

Operative performance feedback is essential for surgical training. We aimed to understand surgical trainees' views on their operative performance feedback needs and to characterize feedback to elucidate factors affecting its value from the resident perspective.

DESIGN

Using a qualitative research approach, 2 research fellows conducted semistructured, one-on-one interviews with surgical trainees. We analyzed recurring themes generated during interviews related to feedback characteristics, as well as the extent to which performance rating tools can help meet trainees' operative feedback needs.

SETTING

Departments or divisions of general or plastic surgery at 9 US academic institutions.

PARTICIPANTS

Surgical residents and clinical fellows in general or plastic surgery.

RESULTS

We conducted 30 interviews with 9 junior residents, 14 senior residents, and 7 clinical fellows. Eighteen (60%) participants were in plastic and 12 (40%) were in general surgery. Twenty-four participants (80%) reported feedback as very or extremely important during surgical training. All trainees stated that verbal, face-to-face feedback is the most valuable, especially if occurring during (92%) or immediately after (65%) cases. Of those trainees using performance rating tools (74%), most (57%) expressed positive views about them but wanted the tools to complement and not replace verbal feedback in surgical education. Trainees value feedback more if received within 1 week or the case.

CONCLUSIONS

Verbal, face-to-face feedback is very or extremely important to surgical trainees. Residents and fellows prefer to receive feedback during or immediately after a case and continue to value feedback if received within 1 week of the event. Performance rating tools can be useful for providing formative feedback and documentation but should not replace verbal, face-to-face feedback. Considering trainee views on feedback may help reduce perceived gaps in feedback demand-versus-supply in surgical training, which may be essential to overcoming current challenges in surgical education.

摘要

目的

手术操作表现反馈对于外科培训至关重要。我们旨在了解外科受训者对其手术操作表现反馈需求的看法,并从住院医师的角度阐明影响反馈价值的因素。

设计

采用定性研究方法,2 名研究人员对外科受训者进行了半结构化的一对一访谈。我们分析了访谈中出现的与反馈特征相关的反复出现的主题,以及绩效评估工具在多大程度上可以帮助满足受训者的手术反馈需求。

地点

9 家美国学术机构的普通或整形外科系或科。

参与者

普通或整形外科的住院医师和临床研究员。

结果

我们对 9 名初级住院医师、14 名高级住院医师和 7 名临床研究员进行了 30 次访谈。18 名(60%)参与者在整形科,12 名(40%)在普通外科。24 名(80%)参与者表示反馈在外科培训中非常或极其重要。所有受训者都表示,口头、面对面的反馈最有价值,尤其是在手术过程中(92%)或手术后立即(65%)进行。在使用绩效评估工具的受训者中(74%),大多数(57%)对其表示肯定,但希望这些工具能补充而非取代外科教育中的口头反馈。如果在 1 周内或手术结束后收到反馈,受训者会更重视反馈。

结论

口头、面对面的反馈对外科受训者非常重要或极其重要。住院医师和研究员更喜欢在手术过程中或手术后立即收到反馈,如果在事件发生后 1 周内收到反馈,他们会继续重视反馈。绩效评估工具可用于提供形成性反馈和文件记录,但不应取代口头、面对面的反馈。考虑到受训者对反馈的看法,可能有助于减少外科培训中反馈需求与供应之间的感知差距,这对于克服当前外科教育挑战可能至关重要。

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