University of Texas Health San Antonio, San Antonio, Texas.
Massachusetts General Hospital, Department of Surgery, Boston, Massachusetts.
J Surg Educ. 2019 May-Jun;76(3):620-627. doi: 10.1016/j.jsurg.2019.01.012. Epub 2019 Feb 13.
The System for Improving and Measuring Procedural Learning (SIMPL) is a smart-phone application used to provide residents with an evaluation of operative autonomy and feedback. This study investigated the perceived benefits and barriers to app use.
A database of previously performed SIMPL evaluations was analyzed to identify high, low, and never users. Potential predisposing factors to use were explored. A survey investigating key areas of value and barriers to use for the SIMPL application was sent to resident and faculty users. Respondents were asked to self-identify how often they used the app. The perceived benefits and barriers were correlated with the level of usage. Qualitative analysis of free text responses was used to determine strategies to increase usage.
General surgery training programs who are members of the Procedural Learning and Safety Collaborative.
Surgical residents and faculty.
At least 1 SIMPL evaluation was created for 411 residents and 524 faculty. Thirty percent of both faculty and residents were high-frequency users. Thirty percent of faculty were never users. One hundred eighty-eight residents and 207 faculty (response rate 46%) completed the survey. High-frequency resident users were more likely to perceive a benefit for both numerical evaluations (76% vs 30%) and dictated feedback (92% vs 30%). Faculty and residents commonly blamed each other for not creating and completing evaluations regularly (87% of residents, 81% of faculty). Suggested strategies to increase usage included reminders and integration with existing data systems.
Frequent users perceive value from the application, particularly from dictated feedback and see a positive impact on feedback in their programs. Faculty engagement represents a major barrier to adoption. Mechanisms which automatically remind residents to initiate an evaluation will help improve utilization but programs must work to enhance faculty willingness to respond and dictate feedback.
SIMPL(改善和测量手术操作学习系统)是一款智能手机应用程序,用于为住院医师提供手术自主性评估和反馈。本研究旨在调查应用程序使用的感知益处和障碍。
分析先前完成的 SIMPL 评估数据库,以确定高、低和从不使用者。探讨使用该应用程序的潜在倾向性因素。向住院医师和教员用户发送了一项调查,内容是评估 SIMPL 应用程序的关键价值领域和使用障碍。被调查者被要求自行确定他们使用该应用程序的频率。感知益处和障碍与使用水平相关联。使用自由文本响应的定性分析来确定增加使用量的策略。
是程序学习和安全协作会的普通外科培训项目成员。
外科住院医师和教员。
至少有 1 次 SIMPL 评估是为 411 名住院医师和 524 名教员创建的。30%的住院医师和教员是高频使用者。30%的教员从未使用过该应用程序。188 名住院医师和 207 名教员(回应率为 46%)完成了调查。高频住院医师使用者更有可能感知到数值评估(76%比 30%)和口述反馈(92%比 30%)的好处。教员和住院医师经常相互指责对方没有定期创建和完成评估(87%的住院医师,81%的教员)。增加使用率的建议策略包括提醒和与现有数据系统的集成。
高频使用者从应用程序中获得了价值,特别是从口述反馈中,并且看到了对他们所在项目中反馈的积极影响。教员参与是采用的主要障碍。自动提醒住院医师启动评估的机制将有助于提高利用率,但程序必须努力增强教员愿意回应和口述反馈的意愿。