Department of Urological Surgery, Barwon Health, University Hospital, Geelong, Victoria, Australia.
Monash University Department of Rural Health, Latrobe Regional Hospital, Traralgon, Victoria, Australia.
ANZ J Surg. 2020 Jun;90(6):991-996. doi: 10.1111/ans.15825. Epub 2020 Mar 16.
Urological surgical trainees who underperform are difficult to identify, manage and require significant resources in an already stretched system relying on pro bono supervisors that often have no formal training. While there are commentaries on how to manage underperforming surgical trainees, there is a lack of data detailing the complex reasons for underperformance. It is important to understand the complexities contributing to underperformance so that improved remediation plans can be developed which can better help trainees meet expectations and succeed.
In this qualitative study, individual semi-structured interviews were conducted with key persons identified as having very high levels of background knowledge and involvement with current underperforming urological surgery trainees. Transcribed interviews were thematically analysed.
Ten interviews were conducted, including nine urology consultants and one educational manager. Five themes were identified: underperformance is a small but profound issue; spiral of failure; the changing trainee; lack of insight and under supported supervisors and posts.
Causes of underperformance in urology trainees are complex and multifactorial. Behavioural issues were considered the most likely cause, which are also the most challenging to remedy. However, in addition to trainee factors, causative factors related to supervision and training were identified. Addressing all of these issues is paramount if effective remediation of these trainees is to occur.
表现不佳的泌尿科手术培训师难以识别、管理，并且在已经依赖于无偿监督者的紧张系统中需要大量资源，而这些监督者通常没有接受过正式培训。虽然有关于如何管理表现不佳的外科培训师的评论，但缺乏详细说明表现不佳的复杂原因的数据。了解导致表现不佳的复杂性很重要，以便制定更好的补救计划，帮助培训师更好地满足期望并取得成功。
在这项定性研究中，对被确定为具有非常高的背景知识和当前表现不佳的泌尿科手术培训师相关知识的关键人员进行了个人半结构化访谈。转录的访谈进行了主题分析。
进行了 10 次访谈，包括 9 名泌尿科顾问和 1 名教育经理。确定了五个主题：表现不佳是一个小而深远的问题；失败的螺旋；不断变化的培训生；缺乏洞察力和支持不足的监督者和职位。
泌尿科培训师表现不佳的原因是复杂的和多因素的。行为问题被认为是最有可能的原因，也是最难纠正的原因。然而，除了培训师因素外，还确定了与监督和培训相关的促成因素。如果要对这些培训师进行有效的补救，解决所有这些问题至关重要。
