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住院医师培训期间长期脱离研究导致的能力衰退:一项范围综述

Decay of Competence with Extended Research Absences During Residency Training: A Scoping Review.

作者信息

Gawad Nada, Allen Molly, Fowler Amanda

机构信息

Surgery, University of Ottawa, Ottawa, CAN.

Emergency Medicine, University of Toronto, Toronto, CAN.

出版信息

Cureus. 2019 Oct 22;11(10):e5971. doi: 10.7759/cureus.5971.

Abstract

A significant number of residents in postgraduate training programs pursue dedicated research training. Currently, no formal curricula exist to transition residents back into clinical roles following dedicated research leave. This scoping review aims to determine what literature exists on the challenges faced by trainees who interrupt their clinical training for extended periods of time for research leave. The Pubmed and Medline databases were searched for all study designs related to postgraduate trainees taking academic or research leave. A three-step selection process including title, abstract and full-article review was employed to identify articles that mentioned decay of knowledge, skill or competence. A narrative review of the literature was generated to present key themes identified within the studies. The search yielded 174 articles of which five investigated resident skill decay during research leave. The five studies included for analysis were cohort studies that used general surgery residents' self-perception and faculty members' perception of residents' skill decay as a measure. Residents and faculty perceived decay of residents' technical skills, leadership skills and knowledge following dedicated research leave. The greatest decay perceived was in technical skills, specifically with more complex tasks and longer periods of non-use. This review identified that residents and faculty perceive a decay of resident skills following dedicated research training. To provide the necessary support to limit this potential decay, as well as to assist in the transition back into clinical training, the needs of and challenges faced by research residents and postgraduate programs must be better understood.

摘要

相当数量的参加研究生培训项目的住院医师会接受专门的研究培训。目前,尚无正式的课程安排,以便让住院医师在休完专门的研究假后重新回归临床岗位。本综述旨在确定现有哪些文献探讨了因长期休研究假而中断临床培训的学员所面临的挑战。我们在PubMed和Medline数据库中搜索了与研究生学员休学术假或研究假相关的所有研究设计。采用了包括标题、摘要和全文审查在内的三步筛选流程,以识别提及知识、技能或能力衰退的文章。我们对文献进行了叙述性综述,以呈现研究中确定的关键主题。搜索共得到174篇文章,其中5篇研究了住院医师在研究假期间的技能衰退情况。纳入分析的5项研究均为队列研究,这些研究将普通外科住院医师的自我认知以及教员对住院医师技能衰退的认知作为衡量指标。住院医师和教员均察觉到,在休完专门的研究假后,住院医师的技术技能、领导能力和知识出现了衰退。人们察觉到衰退最明显的是技术技能,尤其是在处理更复杂的任务以及较长时间未使用这些技能的情况下。本综述表明,住院医师和教员都察觉到在接受专门的研究培训后,住院医师的技能出现了衰退。为了提供必要的支持以限制这种潜在的衰退,并协助他们重新回归临床培训,必须更好地了解研究型住院医师和研究生项目的需求以及所面临的挑战。

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