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外科指导中伦理问题的系统综述

A Systematic Scoping Review of Ethical Issues in Mentoring in Surgery.

作者信息

Lee Fion Qian Hui, Chua Wen Jie, Cheong Clarissa Wei Shuen, Tay Kuang Teck, Hian Eugene Koh Yong, Chin Annelissa Mien Chew, Toh Ying Pin, Mason Stephen, Krishna Lalit Kumar Radha

机构信息

Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore.

出版信息

J Med Educ Curric Dev. 2019 Dec 19;6:2382120519888915. doi: 10.1177/2382120519888915. eCollection 2019 Jan-Dec.

Abstract

BACKGROUND

Mentoring is crucial to the growth and development of mentors, mentees, and host organisations. Yet, the process of mentoring in surgery is poorly understood and increasingly mired in ethical concerns that compromise the quality of mentorship and prevent mentors, mentees, and host organisations from maximising its full potential. A systematic scoping review was undertaken to map the ethical issues in surgical mentoring to enhance understanding, assessment, and guidance on ethical conduct.

METHODS

Arksey and O'Malley's methodological framework was used to guide a systematic scoping review involving articles published between January 1, 2000 and December 31, 2018 in PubMed, Embase, Scopus, ERIC, ScienceDirect, Mednar, and OpenGrey databases. Braun and Clarke's thematic analysis approach was adopted to compare ethical issues in surgical mentoring across different settings, mentee and mentor populations, and host organisations.

RESULTS

A total of 3849 abstracts were identified, 464 full-text articles were retrieved, and 50 articles were included. The 3 themes concerned ethical lapses at the levels of mentor or mentee, mentoring relationships, and host organisation.

CONCLUSIONS

Mentoring abuse in surgery involves lapses in conduct, understanding of roles and responsibilities, poor alignment of expectations, and a lack of clear standards of practice. It is only with better structuring of mentoring processes and effective support of host organisation tasked with providing timely, longitudinal, and holistic assessment and oversight will surgical mentoring overcome prevailing ethical concerns surrounding it.

摘要

背景

指导对指导者、被指导者和主办机构的成长与发展至关重要。然而,外科手术领域的指导过程却鲜为人知,且越来越多地陷入伦理问题之中,这些问题损害了指导的质量,阻碍了指导者、被指导者和主办机构充分发挥其全部潜力。我们进行了一项系统的范围综述,以梳理外科手术指导中的伦理问题,从而增进对伦理行为的理解、评估和指导。

方法

采用阿克西和奥马利的方法框架,指导一项系统的范围综述,该综述涉及2000年1月1日至2018年12月31日期间在PubMed、Embase、Scopus、ERIC、ScienceDirect、Mednar和OpenGrey数据库中发表的文章。采用布劳恩和克拉克的主题分析方法,比较不同环境、被指导者和指导者群体以及主办机构中外科手术指导的伦理问题。

结果

共识别出3849篇摘要,检索到464篇全文文章,纳入50篇文章。这三个主题涉及指导者或被指导者层面的道德失误、指导关系以及主办机构。

结论

外科手术中的指导滥用涉及行为失误、对角色和责任的理解不足、期望不一致以及缺乏明确的实践标准。只有更好地构建指导流程,并由负责提供及时、长期和全面评估及监督的主办机构提供有效支持,外科手术指导才能克服围绕它的普遍伦理问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c24/6923696/9ccfa01236b8/10.1177_2382120519888915-fig1.jpg

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