Office of Surgical Education, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada; Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Office of Surgical Education, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
J Surg Educ. 2019 May-Jun;76(3):756-761. doi: 10.1016/j.jsurg.2018.11.006. Epub 2018 Nov 30.
Being a strong health advocate is recognized as being an important part of being a good surgeon. Residency training programs have struggled with teaching health advocacy beyond didactic sessions, and in a way that encourages trainees to incorporate changes into their practice. This curriculum development aimed to incorporate reflective practice to encourage patient compassion and advocacy.
Community service was incorporated as a mandatory component of a postgraduate surgical training program. Residents participated in a community service activity, and reflected upon their learning with a presentation to their peers.
Mandatory advocacy curriculum for all 67 first and second year surgical residents. Sixty-four residents chose to participate in a community service activity. Forty-six residents completed year end evaluations on the curriculum.
Seventy percent of outreach activities were medically related, and 30% nonmedical. Most residents felt that the amount of work required to complete this project was reasonable (90%), and learned from their experiences (76%). Residents who participated in medically related projects self-described greater learning from their activity (93%), and from watching their peer presentations (79%). These trainees were also more likely to alter their patient management based on their experiences (68%). Trainees who participated in nonmedically related outreach projects were less likely to self-reflect learning from their experiences. Despite mandatory teaching in health advocacy, trainees are often unaware of this teaching within their curriculum.
A mandatory outreach project in residency can encourage trainees to reflect on their volunteer activities as a physician and how it impacts their patient's health. Academic departments should try to encourage volunteerism within their trainees by providing opportunities for residents to participate in outreach activities related to their specialty.
作为一名优秀外科医生,倡导健康被认为是其重要职责之一。住院医师培训计划一直在努力探索如何通过实践教学以外的方式教授健康倡导,鼓励学员将其付诸实践。本课程旨在通过反思实践来鼓励医患共情和倡导。
社区服务被纳入研究生外科培训计划的必修部分。住院医师参加社区服务活动,并通过向同行展示来反思自己的学习。
所有 67 名第一和第二年外科住院医师必修倡导课程。64 名住院医师选择参加社区服务活动。46 名住院医师完成了对该课程的年终评估。
70%的外展活动与医疗相关,30%与医疗无关。大多数住院医师认为完成该项目所需的工作量合理(90%),并从他们的经验中学习(76%)。参与医疗相关项目的住院医师自我描述从他们的活动中(93%)和观看他们同行的演讲(79%)中获得了更多的学习。这些学员也更有可能根据自己的经验改变他们的患者管理(68%)。参与非医疗相关外展项目的学员不太可能从自己的经验中反思学习。尽管在住院医师培训中强制进行健康倡导教学,但学员往往不知道自己的课程中有此教学。
住院医师强制性的外展项目可以鼓励学员反思自己作为医生的志愿活动以及它如何影响患者的健康。学术部门应通过提供机会让住院医师参与与其专业相关的外展活动,鼓励学员参与志愿活动。