Division of Surgical Oncology, Department of Surgery, Wexner Medical Center and James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.
Division of Surgical Oncology, Department of Surgery, Wexner Medical Center and James Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.
J Surg Res. 2020 Jul;251:275-280. doi: 10.1016/j.jss.2020.02.014. Epub 2020 Mar 17.
Treating patients with breast cancer is multidisciplinary; however, it is unclear whether surgery residency programs provide sufficient training in multidisciplinary care. Self-efficacy is one way of measuring the adequacy of training. Our goal was to develop a method of assessing self-efficacy in multidisciplinary breast cancer care.
Based on a literature review and subject-matter expert input, we developed a 30-item self-efficacy survey to measure six domains of breast cancer care (genetics, surgery, medical oncology, radiation oncology, pathology, and radiology). We constructed and validated the survey using a seven-step survey development framework. The survey was administered to general surgery residents at a single academic surgical residency.
Response rate was 66% (n = 31). Internal consistency was strong (Cronbach alpha = 0.92). Self-efficacy was moderate (mean = 3.05) and tended to increase with training (postgraduate year [PGY] 1: mean= 2.37 versus PGY 5: mean= 3.54; P < 0.001), providing evidence for construct validity. Self-efficacy was highest in the surgery (3.56) compared with others (genetics 2.67, medical oncology 3, radiation oncology 2.67, pathology 2.67, and radiology 3.33). This trend was similar across all PGY groups, except for interns, whose self-efficacy in surgery was low.
We created a survey to assess self-efficacy in multidisciplinary breast cancer care and provided initial evidence of survey validity. Although self-efficacy in surgery improved with years in training, medical and radiation oncology self-efficacy remained low. As modern breast cancer treatment is highly multidisciplinary, an expanded education program is needed to help trainees incorporate multidisciplinary clinical perspectives.
治疗乳腺癌患者需要多学科合作；然而，目前尚不清楚外科住院医师培训项目是否提供了足够的多学科护理培训。自我效能感是衡量培训是否充分的一种方式。我们的目标是开发一种评估多学科乳腺癌护理自我效能的方法。
基于文献回顾和主题专家的意见，我们开发了一个 30 项的自我效能感调查，以衡量乳腺癌护理的六个领域（遗传学、手术、肿瘤内科、放射肿瘤学、病理学和放射学）。我们使用一个七步调查开发框架构建并验证了该调查。该调查在一个学术外科住院医师培训项目中的普通外科住院医师中进行。
回复率为 66%（n=31）。内部一致性很强（Cronbach alpha=0.92）。自我效能感中等（平均值=3.05），并随着培训而增加（第 1 年住院医师：平均值=2.37 与第 5 年住院医师：平均值=3.54；P<0.001），这提供了结构有效性的证据。手术的自我效能感最高（3.56），而其他学科的自我效能感较低（遗传学 2.67、肿瘤内科 3、放射肿瘤学 2.67、病理学 2.67、放射学 3.33）。这种趋势在所有住院医师组中都相似，除了实习生，他们在手术中的自我效能感较低。
我们创建了一个评估多学科乳腺癌护理自我效能的调查，并提供了调查有效性的初步证据。尽管随着培训年限的增加，手术中的自我效能感有所提高，但医学和放射肿瘤学的自我效能感仍然较低。由于现代乳腺癌治疗高度多学科化，需要一个扩展的教育计划来帮助受训者融入多学科的临床观点。
