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围手术期教学与反馈:加拿大耳鼻喉头颈外科住院医师培训项目实施情况如何?

Perioperative Teaching and Feedback: How are we doing in Canadian OTL-HNS programs?

机构信息

Department of Medicine, McGill University, Montreal, Canada.

Department of Otolaryngology - Head and Neck Surgery, McGill University, 1001 Decarie Boulevard, Room A02-3015, Montreal, Quebec, H4A 3J1, Canada.

出版信息

J Otolaryngol Head Neck Surg. 2019 Jan 17;48(1):6. doi: 10.1186/s40463-019-0330-2.

Abstract

BACKGROUND

Discrepancies between resident and faculty perceptions regarding optimal teaching and feedback during surgery are well known but these differences have not yet been described in Otolaryngology - Head and Neck Surgery (OTL-HNS). The objectives were thus to compare faculty and resident perceptions of perioperative teaching and feedback in OTL-HNS residency programs across Canada with the aim of highlighting potential areas for improvement.

METHODS

An anonymous electronic questionnaire was distributed to residents and teaching faculty in OTL-HNS across Canada with additional paper copies distributed at four institutions. Surveys consisted of ratings on a 5-point Likert scale and open-ended questions. Responses among groups were analysed with the Wilcoxon-Mann Whitney test, while thematic analysis was used for the open-ended questions.

RESULTS

A total of 143 teaching faculty and residents responded with statistically significant differences on 11 out of 25 variables. Namely, faculty reported higher rates of pre and intra-operative teaching compared to resident reports. Faculty also felt they gave adequate feedback on residents' strengths and technical skills contrary to what the residents thought. Both groups did agree however that pre-operative discussion is not consistently done, nor is feedback consistently given or sought.

CONCLUSION

Faculty and residents in OTL-HNS residency programs disagree on the frequency and optimal timing of peri-operative teaching and feedback. This difference in perception emphasizes the need for a more structured approach to feedback delivery including explicitly stating when feedback is being given, and the overall need for better communication between residents and staff.

摘要

背景

住院医师和教员对手术期间最佳教学和反馈的看法存在差异,这是众所周知的,但尚未在耳鼻喉科(OTL-HNS)中描述这些差异。因此,本研究的目的是比较加拿大各地的耳鼻喉科住院医师培训计划中教员和住院医师对围手术期教学和反馈的看法,旨在强调潜在的改进领域。

方法

向加拿大各地的耳鼻喉科教员和住院医师分发了一份匿名电子问卷,并在四所机构分发了额外的纸质副本。调查包括 5 点李克特量表的评分和开放式问题。使用 Wilcoxon-Mann Whitney 检验分析组间的反应,同时使用主题分析处理开放式问题。

结果

共有 143 名教学教员和住院医师做出了回应,在 25 个变量中的 11 个变量上存在统计学差异。具体来说,与住院医师的报告相比,教员报告了更高的术前和术中教学率。教员还认为他们对住院医师的优势和技术技能给予了足够的反馈,而这与住院医师的想法相反。然而,两组都认为,并非始终进行术前讨论,也并非始终给予或寻求反馈。

结论

耳鼻喉科住院医师培训计划中的教员和住院医师在围手术期教学和反馈的频率和最佳时间上存在分歧。这种看法上的差异强调了需要更结构化的反馈方法,包括明确说明何时给予反馈,以及住院医师和工作人员之间需要更好的沟通。

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