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白沙瓦肾病研究所泌尿外科研究生培训中操作技能直接观察法(DOPS)的有效性

Effectiveness of Direct Observation of Procedural Skills (DOPS) in Postgraduate Training in Urology at Institute of Kidney Diseases, Peshawar.

作者信息

Ali Liaqat, Ali Saima, Orakzai Nasir, Ali Naila

机构信息

Department of Urology, Institute of Kidney Diseases (IKD), Hayatabad Medical Complex, Peshawar, Pakistan.

Department of Paediatric Medicine, Peshawar Medical College, Peshawar.

出版信息

J Coll Physicians Surg Pak. 2019 Jun;29(6):516-519. doi: 10.29271/jcpsp.2019.06.516.

Abstract

OBJECTIVE

To determine the effectiveness of direct observation of procedural skills (DOPS) in the assessment and improving operative skills of postgraduate residents in urology.

STUDY DESIGN

Comparative study.

PLACE AND DURATION OF STUDY

Department of Urology, Institute of Kidney Diseases (IKD), Hayatabad Medical Complex, Peshawar, from March till December 2016.

METHODOLOGY

Twenty postgraduate residents in urology were assessed for three commonly performed procedures in urology with structured proforma, specially designed for DOPS, using Likert scale from 1 to 5. Formative feedback was given to all the residents highlighting their strengths and weaknesses. During second phase, all the three procedures were performed by four consultants respectively with residents as learner in the second phase of DOPS. During the third phase, a repeat assessment of e-residents was performed to study the overall improvement in operative skills, respectively.

RESULTS

In pre-DOPS assessment, only 7 (35%) out of 20 residents, passed in skill of cystoscopy, 6 (30%) residents passed in transurethral resection of prostate (TURP), while 3 (15%) residents passed in skills of uretero-renoscopy (URS). The mean score of overall ability to perform procedure during first phase of DOPS were 2.7 ±1.3 for cystoscopy, 2.1 ±0.97 for TURP, and 2.5 ±1.1 for ureterorenoscopy. Significant improvement (p 0.04) in passing was observed in third phase with 17 (85%), 14 (70%), and 14 (70%) residents were declared passed in cystoscopy, TURP and URS, respectively. The mean score of overall ability to perform procedure during the third phase was 4.7 ±0.7 for cystoscopy, 4.5 ±0.94 for TURP, and 4.7 ±0.94 for ureteroscopy.

CONCLUSION

DOPS is effective tool for assessing and improving the skills of postgraduate residents in urology.

摘要

目的

确定直接观察操作技能(DOPS)在评估和提高泌尿外科研究生住院医师手术技能方面的有效性。

研究设计

对比研究。

研究地点和时间

白沙瓦哈亚塔巴德医疗中心肾病研究所泌尿外科,2016年3月至12月。

方法

使用专门为DOPS设计的结构化表格,采用1至5的李克特量表,对20名泌尿外科研究生住院医师进行三项常见泌尿外科手术的评估。向所有住院医师提供形成性反馈,突出他们的优点和缺点。在第二阶段,由四位顾问分别进行这三项手术,住院医师在DOPS的第二阶段作为学习者。在第三阶段,对住院医师进行重复评估,以分别研究手术技能的整体提高情况。

结果

在DOPS前评估中,20名住院医师中只有7名(35%)膀胱镜检查技能合格,6名(30%)经尿道前列腺切除术(TURP)技能合格,而3名(15%)输尿管肾镜检查(URS)技能合格。DOPS第一阶段手术操作总体能力的平均得分,膀胱镜检查为2.7±1.3,TURP为2.1±0.97,输尿管肾镜检查为2.5±1.1。在第三阶段观察到通过率有显著提高(p<0.04),膀胱镜检查、TURP和URS分别有17名(85%)、14名(70%)和14名(70%)住院医师被宣布合格。第三阶段手术操作总体能力的平均得分,膀胱镜检查为4.7±0.7,TURP为4.5±0.94,输尿管镜检查为4.7±0.94。

结论

DOPS是评估和提高泌尿外科研究生住院医师技能的有效工具。

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