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住院医师对同行主导和住院医师主导的外科服务的看法和评价。

Resident perceptions and evaluations of fellow-led and resident-led surgical services.

机构信息

Department of Surgery, University of Michigan, Ann Arbor, MI, USA.

Department of Surgery, University of Michigan, Ann Arbor, MI, USA.

出版信息

Am J Surg. 2019 Feb;217(2):373-381. doi: 10.1016/j.amjsurg.2018.09.005. Epub 2018 Sep 7.

DOI:10.1016/j.amjsurg.2018.09.005
PMID:30224072
Abstract

BACKGROUND

The impact of fellowship training on general surgery residency has remained challenging to assess. Surgical resident perceptions of fellow-led and resident-led surgical services have not been well described.

METHODS

Retrospective cross-sectional data were collected from residents' service evaluations from 7/2014 through 7/2017. Surgical services were categorized as resident-led or fellow-led. 31 variables were evaluated and collapsed into 7 factors including clinical experience, educational experiences, clinical staff, workload, feedback, treatment of residents, and overall rotation.

RESULTS

Among all PGY levels, fellow-led surgical services were rated significantly higher (p < 0.05) regarding clinical experience, clinical staff, treatment of residents, and overall rotation. PGY1-2 residents rated resident-led services significantly higher in the area of educational experiences, while PGY 3 residents rated resident-led services higher in the area of workload. However, PGY4-5 residents rated fellow-led services significantly higher in all 7 categories. Individual fellow-led services were rated significantly higher for various categories at different PGY levels.

CONCLUSIONS

Surgical residents appear to value the educational experiences of fellow-led services. Each fellow-led service may ultimately provide unique educational opportunities and resources for different PGY levels.

摘要

背景

Fellowship 培训对普通外科住院医师培训的影响仍然难以评估。外科住院医师对由研究员领导和住院医师领导的外科服务的看法尚未得到很好的描述。

方法

从 2014 年 7 月至 2017 年 7 月，从住院医师的服务评估中收集了回顾性的横截面数据。外科服务分为住院医师主导和研究员主导。评估了 31 个变量，并将其合并为 7 个因素，包括临床经验、教育经验、临床工作人员、工作量、反馈、对住院医师的治疗以及整体旋转。

结果

在所有 PGY 水平中，研究员主导的外科服务在临床经验、临床工作人员、对住院医师的治疗和整体旋转方面的评分明显更高（p < 0.05）。PGY1-2 住院医师在教育经验领域对住院医师主导的服务评分明显更高，而 PGY3 住院医师在工作量领域对住院医师主导的服务评分更高。然而，PGY4-5 住院医师在所有 7 个类别中对研究员主导的服务评分明显更高。不同 PGY 水平的个别研究员主导的服务在各个类别中的评分都更高。

结论

外科住院医师似乎重视研究员主导服务的教育经验。每个研究员主导的服务可能最终为不同的 PGY 水平提供独特的教育机会和资源。

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