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耳鼻喉科住院医师关键指标病例的经验。

Experience with key indicator cases among otolaryngology residents.

作者信息

O'Brien Daniel C, Kellermeyer Brian, Chung Jeffson, Carr Michele M

机构信息

Department of Otolaryngology-Head and Neck Surgery University of West Virginia Morgantown West Virginia U.S.A.

Silverstein Institute Sarasota Florida U.S.A.

出版信息

Laryngoscope Investig Otolaryngol. 2019 Jul 17;4(4):387-392. doi: 10.1002/lio2.274. eCollection 2019 Aug.

Abstract

OBJECTIVE

To describe the resident experience with respect to key indicator cases for each year of training.

STUDY DESIGN

Multi-institution, cross-sectional assessment.

METHODS

Using an electronic survey, current otolaryngology residents were solicited to complete a survey regarding their experiences with the key indicator cases to that point. The survey was sent to this cohort in the winter of 2017-2018.

RESULTS

Three hundred and three residents responded, with 293 completing the survey. Twenty-three percent were PGY1, 19% PGY2, 21% PGY3, 18% PGY4, and 19% PGY5 or higher. The majority of residents progress from resident assistant as a PGY2, to resident surgeon as a PGY3 and self-assessed competent surgeon as a PGY4 for the majority of the key indicator cases. Less than 50% of the surveyed PGY5 residents had reached independent practice in all the key indicator cases, with stapedectomy (16%), rhinoplasty (18%), and paramedian forehead flap (14.5%) being the cases least frequently performed independently. Ninety-five percent of the respondent residents felt their program provided adequate training, but 20% of the respondents were either unsure or believed that they would be unable to perform all the key indicator cases by the completion of their training.

CONCLUSIONS

The majority of otolaryngology residents feel confident in their training, but experience with certain cases lags behind and may not currently be taught as resident level cases. These findings raise the question of whether the current key indicator cases are the best option for assessing breadth and depth of residency training.

LEVEL OF EVIDENCE

NA.

摘要

目的

描述住院医师在培训各年中有关关键指标病例的经历。

研究设计

多机构横断面评估。

方法

通过电子调查问卷,邀请现任耳鼻喉科住院医师完成一份关于他们当时对关键指标病例的经历的调查问卷。该问卷于2017 - 2018年冬季发送给这一队列的住院医师。

结果

303名住院医师回复,293名完成了调查。23%为第一年住院医师(PGY1),19%为第二年住院医师(PGY2),21%为第三年住院医师(PGY3),18%为第四年住院医师(PGY4),19%为第五年及更高年资住院医师(PGY5)。大多数住院医师从PGY2时的住院医师助理,发展到PGY3时的住院医师外科医生,并在大多数关键指标病例中自我评估为PGY4时具备胜任能力的外科医生。在接受调查的PGY5住院医师中,不到一半在所有关键指标病例中达到独立操作水平,其中镫骨切除术(16%)、鼻整形术(18%)和正中旁额部皮瓣手术(14.5%)是最不常独立进行的手术。95%的受访住院医师认为他们的培训项目提供了充分的培训,但20%的受访者不确定或认为在培训结束时他们无法完成所有关键指标病例。

结论

大多数耳鼻喉科住院医师对他们的培训感到自信,但某些病例的经验滞后,目前可能未作为住院医师水平的病例进行教授。这些发现提出了当前关键指标病例是否是评估住院医师培训广度和深度的最佳选择这一问题。

证据级别

无。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2671/6703116/ea2d72c18efa/LIO2-4-387-g001.jpg

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