Riley Charles A, Soneru Christian P, Husain Qasim, Gray Stacey T, Senior Brent A, Tabaee Abtin
1 Department of Otolaryngology - Head and Neck Surgery, Weill Cornell Medicine - New York Presbyterian Hospital, New York, New York.
2 Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.
Am J Rhinol Allergy. 2019 Jan;33(1):8-16. doi: 10.1177/1945892418801403. Epub 2018 Oct 3.
The number of rhinology fellowship programs has grown rapidly over the past decade. To date, no standardization or accreditation process exists, raising the potential for disparate programs. The attitudes of faculty regarding training are important to elucidate the educational experience of rhinology fellowship.
An anonymous, web-based survey of rhinology faculty assessed the subjective attitudes toward various domains of fellowship training including surgery, office-based procedures, research, and career development. A 5-point Likert-type scale assessing importance was used (1-not at all important, 5-extremely important).
A total of 34 faculty (response rate 35.8%) completed the survey. The surgical procedures that received the highest mean importance scores were endoscopic surgery for advanced inflammatory disease (median = 5), cerebrospinal fluid leak closure (5), and extended endoscopic sinus surgery (5). The procedures with the lowest scores were nasal valve repair (2), inferior turbinate surgery (3), and open approaches to the sinuses (4). A wide range of responses was noted for the minimum target number of fellow cases for the surveyed procedures. Higher importance scores were noted for direct attending supervision (5) when compared to fellow autonomy (4, P < .001) or shadowing (3.5, P < .001) in the operating room. Higher scores were noted for career preparation in academic (4) versus private practice (3, P < .001) and providing opportunities for clinical (4) versus basic science research (2, P < .001). The majority of faculty felt that there were too many fellowship positions with respect to the market place for private practice (58.8%), academic jobs (85.3%), and overall societal need (61.8%).
A range of faculty attitudes with respect to fellowship training was noted in this study. Continued assessment and refinement of the educational experience in rhinology fellowships is necessary.
在过去十年中，鼻科学 fellowship 项目的数量迅速增长。迄今为止，尚无标准化或认证程序，这增加了不同项目之间存在差异的可能性。教员对培训的态度对于阐明鼻科学 fellowship 的教育体验很重要。
对鼻科学教员进行了一项基于网络的匿名调查，评估了对 fellowship 培训各个领域的主观态度，包括手术、门诊手术、研究和职业发展。使用了一个 5 点李克特量表来评估重要性（1 - 一点也不重要，5 - 极其重要）。
共有 34 名教员（回复率 35.8%）完成了调查。平均重要性得分最高的手术操作是针对晚期炎症性疾病的内镜手术（中位数 = 5）、脑脊液漏修补术（5）和扩大的内镜鼻窦手术（5）。得分最低的操作是鼻瓣膜修复术（2）、下鼻甲手术（3）和鼻窦开放手术（4）。对于所调查操作的最低目标学员病例数，有广泛的回答。与手术室中学员的自主权（4，P < 0.001）或跟班学习（3.5，P < 0.001）相比，直接上级监督的重要性得分更高（5）。学术职业准备的得分（4）高于私人执业（3，P < 0.001），提供临床机会的得分（4）高于基础科学研究机会（2，P < 0.001）。大多数教员认为，就私人执业的市场需求（58.8%）、学术工作（85.3%）和总体社会需求（61.8%）而言，fellowship 职位过多。
本研究中注意到教员对 fellowship 培训的一系列态度。有必要持续评估和完善鼻科学 fellowship 的教育体验。
