Department of Surgery, University of Michigan Health System, 2207 Taubman Center, 1500 E. Medical Center Dr., Ann Arbor, MI, USA.
Department of Surgery, University of Wisconsin School of Medicine & Public Health, H4/710D Clinical Science Center, 600 Highland Avenue, Madison, WI, USA.
Am J Surg. 2019 Feb;217(2):276-280. doi: 10.1016/j.amjsurg.2018.07.057. Epub 2018 Aug 27.
Faculty entrustment decisions affect resident entrustability behaviors and surgical autonomy. The relationship between entrustability and autonomy is not well understood. This pilot study explores that relationship.
108 case observations were completed. Entrustment behaviors were rated using OpTrust. Residents completed a Zwisch self-assessment to measure surgical autonomy. Resident perceived autonomy was collected for 67 cases used for this pilot study.
Full entrustability was observed in 5 of the 108 observed cases. Residents in our study did not report full autonomy. Spearman's rank correlation coefficient identified that resident entrustability was positively correlated with perceived resident autonomy (ρ = 0.66, p < 0.05). Ordinal logistic regression assessed the relationship between resident entrustability and autonomy. The relationship persisted while controlling for PGY level, gender, and case complexity (OR = 8.42, SEM = 4.54, p < 0.000).
Resident entrustability is positively associated with perceived autonomy, yet full entrustability is not translating to the perception of full autonomy for residents.
教师授权决策影响住院医师的可授权行为和手术自主性。授权和自主性之间的关系尚未得到很好的理解。本初步研究旨在探讨这种关系。
完成了 108 个案例观察。使用 OpTrust 对授权行为进行评分。住院医师完成了 Zwisch 自我评估，以衡量手术自主性。对于本初步研究使用的 67 个案例，收集了住院医师感知的自主性。
在观察到的 108 个案例中，有 5 个案例出现了完全授权。我们研究中的住院医师并未报告完全自主。Spearman 秩相关系数表明住院医师的授权与感知到的住院医师自主性呈正相关（ρ=0.66，p<0.05）。有序逻辑回归评估了住院医师授权和自主性之间的关系。在控制住院医师的 PGY 水平、性别和案例复杂性后，这种关系仍然存在（OR=8.42，SEM=4.54，p<0.000）。
住院医师的授权与感知自主性呈正相关，但完全授权并未转化为住院医师对完全自主性的感知。
Zotero 插件