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比较教师指导与结构化同伴反馈对基本和中级手术技能习得的效果。

Comparison of faculty versus structured peer-feedback for acquisitions of basic and intermediate-level surgical skills.

机构信息

Queen's University, Macklem House, 18 Barrie St., Kingston, Ontario, K7L 3N6, Canada.

出版信息

Am J Surg. 2019 Feb;217(2):214-221. doi: 10.1016/j.amjsurg.2018.06.028. Epub 2018 Jun 30.

Abstract

PURPOSE

Video feedback and faculty feedback has been shown to improve surgical performance; however, consistent access to faculty is challenging. We studied the utility of structured peer-feedback (PF) compared to faculty-feedback (FF) during acquisition of basic and intermediate surgical skills.

METHODOLOGY

Two randomized non-inferiority trials were conducted with 1st (n = 30) and 2nd year (n = 29) medical students learning skin-lesion excision and closure (S), and single-layer hand-sewn bowel anastomosis (B), respectively. Five attempts were performed. PF participants used an Objective Structured Assessment of Technical Skills tool to guide feedback. Blinded raters assessed video-recorded performance, time and Integrity of the completed task were also assessed.

RESULTS

For both tasks performance by PF was comparable to FF (P = 0.111). Both groups improved significantly: performance (B:P < 0.0001, S:P = 0.035), time (B:P = 0.043, S:P < 0.0001) and integrity (B:P < 0.0001, S:P < 0.032).

CONCLUSION

Structured peer-feedback is equivalent to faculty-feedback in the acquisition of basic and intermediate surgical skills, giving students freedom to practice independently.

摘要

目的

视频反馈和教师反馈已被证明可以提高手术表现;然而,要一直获得教师的反馈是具有挑战性的。我们研究了在获得基本和中级手术技能期间,结构化同伴反馈(PF)与教师反馈(FF)的效用。

方法

对一年级(n=30)和二年级(n=29)医学生进行了两项随机非劣效性试验,分别学习皮肤病变切除和闭合(S)以及单层手工肠吻合术(B)。每个任务进行 5 次尝试。PF 参与者使用客观结构化评估技术技能工具来指导反馈。盲法评估者评估了视频记录的表现,还评估了完成任务的时间和完整性。

结果

对于这两个任务,PF 的表现与 FF 相当(P=0.111)。两个组都有显著的提高:表现(B:P<0.0001,S:P=0.035)、时间(B:P=0.043,S:P<0.0001)和完整性(B:P<0.0001,S:P<0.032)。

结论

在获得基本和中级手术技能方面,结构化同伴反馈与教师反馈相当,让学生可以自由独立地练习。

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