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非技术技能培训中沟通与意识的缺失?对外科培训中培训师和学员认知的定性分析。

A Lack of Communication and Awareness in Nontechnical Skills Training? A Qualitative Analysis of the Perceptions of Trainers and Trainees in Surgical Training.

作者信息

Whittaker Joshua D, Davison Ian

机构信息

Otolaryngology, Univerisity Hospitals Nottingham, Nottingham, United Kingdom.

School of Education, Univeristy of Birmingham, Birmingham, United Kingdom.

出版信息

J Surg Educ. 2020 Jul-Aug;77(4):873-888. doi: 10.1016/j.jsurg.2020.01.006. Epub 2020 Feb 6.

Abstract

OBJECTIVE

To examine the perceptions of surgical trainees and trainers towards nontechnical skills (NTS) as a concept, its role in training, and the challenges of developing these skills.

DESIGN

A case series of semistructured interviews using an interpretivist grounded theory approach for qualitative analysis.

SETTING

East Midlands (North) core surgical training programme in the United Kingdom.

PARTICIPANTS

Ten out of 81 volunteer core surgical trainees and academic educational supervisors (consultant surgeon trainers).

RESULTS

Understanding of NTS was consistent amongst trainers and trainees but the conceived definition of NTS was much broader than previous definitions. Most viewed NTS as important for surgeons. Trainees believed trainers did not appreciate or were unaware of NTS, likely because of a lack of discussion in practice. Trainers had several reasons for not discussing NTS including insufficient personal relationships with trainees and a lack of robust evidence on which to base discussions. A lack of insight into NTS and surgeon arrogance were suggested as barrier to effective learning.

CONCLUSIONS

Apparent discordant perceptions may be contributing to a lack of focused NTS feedback for surgeons in training. To implement NTS training changes, more will have to be done to develop a shared understanding.

摘要

目的

探讨外科住院医师和培训师对非技术技能(NTS)这一概念的认知、其在培训中的作用以及培养这些技能所面临的挑战。

设计

采用诠释性扎根理论方法进行定性分析的一系列半结构化访谈案例。

背景

英国东米德兰兹(北部)核心外科培训项目。

参与者

81名志愿核心外科住院医师和学术教育督导(顾问外科培训师)中的10人。

结果

培训师和住院医师对NTS的理解一致,但NTS的概念定义比以往的定义宽泛得多。大多数人认为NTS对外科医生很重要。住院医师认为培训师不重视或不了解NTS,可能是因为在实践中缺乏相关讨论。培训师不讨论NTS有几个原因,包括与住院医师的个人关系不足以及缺乏进行讨论的有力证据。对NTS缺乏洞察力和外科医生的傲慢被认为是有效学习的障碍。

结论

明显不一致的认知可能导致在培训中的外科医生缺乏针对性的NTS反馈。要实施NTS培训变革,还需要做更多工作以达成共同理解。

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