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作为教室的手术室:关于医学生在手术室环境中学习的文献综述

The operating theatre as a classroom: a literature review of medical student learning in the theatre environment.

作者信息

Croghan Stefanie M, Phillips Catherine, Howson William

机构信息

University College London, Postgraduate Department of Medical Sciences, UCL Medical School, UK.

出版信息

Int J Med Educ. 2019 Apr 23;10:75-87. doi: 10.5116/ijme.5ca7.afd1.

Abstract

OBJECTIVES

We set out to review the published literature relating to the educational experiences of medical students in the operating theatre.  In particular, we wished to deduce from the current evidence what challenges are posed to student learning in this environment, and how they may be overcome.

METHODS

National Library of Medicine and Google Scholar databases were searched from 1990-2018, using search terms 'Operating Theatre,' OR 'Operating Theater,' OR 'Operating Room' AND 'Medical Students.' Title and abstract review of 679 papers were performed.  Full-text English language papers about the learning or satisfaction of medical students in the theatre environment were included.  Papers exploring the experiences of residents/trainees rather than medical students were excluded.  A total of 36 papers were eligible for inclusion.  Thematic analysis was conducted on these papers.

RESULTS

A number of common themes were identified.  Throughout the literature, medical students describe a lack of clear learning objectives, fear, anxiety, feelings of humiliation and intimidation, lack of visualisation and lack of opportunity for participation as barriers to their satisfaction with theatre placements and to their subjective learning.

CONCLUSIONS

Obstacles identified by students as deleterious to their experiences in the operating theatre are remarkably reproducible across a number of research studies in different populations.  Areas to address by both individual educators and curriculum designers include fostering a culture of inclusion in theatre, setting explicit, achievable learning goals for students in this environment and making a concerted effort to prepare students for the theatre setting.

摘要

目的

我们着手回顾已发表的有关医学生手术室教育经历的文献。特别是,我们希望从当前证据中推断出在这种环境下学生学习面临哪些挑战,以及如何克服这些挑战。

方法

检索了1990年至2018年期间的美国国立医学图书馆和谷歌学术数据库,使用的检索词为“手术室”(Operating Theatre、Operating Theater或Operating Room)以及“医学生”。对679篇论文进行了标题和摘要审查。纳入了关于医学生在手术室环境中的学习或满意度的全文英文论文。排除了探讨住院医师/实习生而非医学生经历的论文。共有36篇论文符合纳入标准。对这些论文进行了主题分析。

结果

确定了一些共同主题。在整个文献中,医学生将缺乏明确的学习目标、恐惧、焦虑、羞辱感和 intimidation感、缺乏可视化以及缺乏参与机会描述为影响他们对手术室实习满意度和主观学习的障碍。

结论

学生们认为对他们在手术室的经历有害的障碍在不同人群的多项研究中具有显著的可重复性。个体教育工作者和课程设计者都需要解决的领域包括在手术室营造包容的文化氛围,为学生在这种环境中设定明确、可实现的学习目标,并齐心协力让学生为手术室环境做好准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09b7/6766388/2ddaa5f6941b/ijme-10-75-g001.jpg

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