Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
J Pediatr Urol. 2018 Dec;14(6):577-583. doi: 10.1016/j.jpurol.2018.07.026. Epub 2018 Aug 28.
To make surgical training more effective, a proven method is needed to provide feedback to residents on their surgeries. Residency programs may make up for limited training time in the operating room by improving feedback that trainees receive about cases.
The goals of this study were (1) to determine if an online tool to communicate feedback for attendings and trainees shows face validity and (2) to use an online tool to identify the most common feedback trainees receive after performing orchiopexy and hypospadias repair by survey.
In 2016, determining whether an online tool to provide pediatric urology trainees feedback after surgery shows face validity begun. The tool was launched at the authors' institutions. Then, attendings, fellows, and postgraduate year 4-5 trainees of 65 resident training programs were surveyed for their observations on preparing for and performing orchiopexy and hypospadias repair using the study tool to identify common feedback.
The results of using the tool to provide feedback shows face validity are as follows: feedback was exchanged between attendings and trainees on orchiopexy (n = 28) and hypospadias (n = 22). Anecdotally, the tool was easy to use. The results of using the tool to identify the most common feedback trainees receive by survey are as follows: from a pool of 65 institutions, 37 attendings and 28 trainees were enrolled who made 219 observations. Most trainees prepare using undocumented online resources (17/28, 67%) instead of speaking with their attendings or cotrainees (11/28, 33%). For orchiopexy, most respondents reported that trainees need to improve skills for hernia ligation (observations: attending = 28/45, 62%; and trainee = 17/26, 65%) and strategies for hernia exposure (observations: attending = 17/27, 62%; and trainee = 7/12, 58%). For hypospadias, most respondents reported that trainees need to improve skills for neourethroplasty (observations: attending = 31/53, 58%; and trainee = 10/16, 62%) and strategies for repair choice (observations: attending = 15/22, 68%; and trainee = 12/18, 67%) (chi-squared, all P = NS).
It was shown that both trainees and attendings agree on the areas of surgical strategy and execution which require improvement. With this study, it is also shown that the online feedback tool developed shows face validity in allowing attendings and trainees to communicate before and after surgery.
The most common feedback pediatric urology trainees receive for routine pediatric urology surgery is identified. Online tools that emphasize remediations to address a trainee's specific feedback needs are to be built, so that they will be able to improve their skills at their next case.
为了使外科培训更有效，需要有一个经过验证的方法为住院医师提供手术反馈。住院医师培训计划可以通过改善住院医师对病例的反馈，弥补手术室培训时间的不足。
本研究的目的是：(1)确定一种用于主治医生和住院医师之间交流反馈的在线工具是否具有表面有效性；(2)通过调查，使用在线工具确定住院医师在进行睾丸固定术和尿道下裂修复术后最常收到的反馈。
2016 年，开始确定一种用于术后为小儿泌尿科住院医师提供反馈的在线工具是否具有表面有效性。该工具在作者所在的机构推出。然后，对 65 个住院医师培训项目的主治医生、研究员和住院医师 4-5 年级的学员进行了调查，使用研究工具了解他们在准备和进行睾丸固定术和尿道下裂修复术方面的观察结果，以确定常见的反馈。
使用该工具提供反馈的结果具有表面有效性：主治医生和住院医师就睾丸固定术（n=28）和尿道下裂（n=22）进行了反馈。该工具使用起来非常方便。通过调查，使用该工具确定住院医师最常收到的反馈结果如下：在 65 个机构中，有 37 名主治医生和 28 名住院医师参与了 219 次观察。大多数住院医师使用未记录的在线资源进行准备（17/28，67%），而不是与主治医生或同事交谈（11/28，33%）。对于睾丸固定术，大多数受访者报告说，住院医师需要提高疝结扎（观察：主治医生=28/45，62%；住院医师=17/26，65%）和疝暴露（观察：主治医生=17/27，62%；住院医师=7/12，58%）的技能。对于尿道下裂，大多数受访者报告说，住院医师需要提高尿道成形术（观察：主治医生=31/53，58%；住院医师=10/16，62%）和修复选择（观察：主治医生=15/22，68%；住院医师=12/18，67%）的技能（卡方检验，所有 P 值均为非显著）。
研究表明，主治医生和住院医师都同意需要改进手术策略和执行的领域。通过这项研究，还表明开发的在线反馈工具在允许主治医生和住院医师在手术前后进行沟通方面具有表面有效性。
确定了小儿泌尿科住院医师接受常规小儿泌尿科手术的最常见反馈。应建立在线工具，强调针对住院医师具体反馈需求的补救措施，以便他们能够在下一个病例中提高技能。
