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对伊斯坦布尔经认可和未经认可机构的骨科与创伤科住院医师手术技能的调查。

Survey on the surgical skills of orthopedics and traumatology residents from accredited and nonaccredited institutions in İstanbul.

作者信息

Dırvar Ferdi, Uzun Dırvar Sevda, Yıldırım Timur, Cengiz Ömer, Talmaç Mehmet Ali

机构信息

Department of Orthopedics and Traumatology, Metin Sabancı Baltalimanı Bone and Joint Diseases Training and Research Hospital, İstanbul, Turkey.

Department of Education, Metin Sabancı Baltalimanı Bone and Joint Diseases Training and Research Hospital, İstanbul, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2020 Mar;54(2):168-177. doi: 10.5152/j.aott.2020.02.158.


DOI:10.5152/j.aott.2020.02.158
PMID:32254033
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7286170/
Abstract

OBJECTIVE: To investigate whether orthopedic and traumatology residents who are undergoing training achieve competence in surgical techniques after completion of their specialization and to determine whether there are significant differences between the responses of residents from accredited and nonaccredited institutions. METHODS: A total of 131 orthopedics and traumatology residents from nine institutions in the İstanbul province answered the questionnaire during the morning training meeting. In addition to basic demographic data, level of seniority, equipment competence, and theoretical and practical training, the residents were asked about their opinion on what type of surgeries they could perform after their specialization, considering the surgery and follow-up of the case as well as the complications occurring during this period. The residents responded to questions on 46 surgeries under the main headings of trauma, arthroscopy, arthroplasty, spine, pediatric orthopedics, hand surgery, deformity, and bone and soft tissue tumors. In addition to descriptive statistical methods, one-way analysis of variance, Tukey's multiple comparison test, and chi square test were used to evaluate the data. The significance level for the results was set at p<0.05. RESULTS: In total, 131 orthopedics and traumatology residents answered the questionnaire. Furthermore, 53 (40.5%) specialization students were employed at accredited institutions and 78 (59.5%) at nonaccredited institutions. According to the responses, case presentations, article-writing sessions, and in-province meetings held regularly at accredited institutions showed a significant difference compared to non-accredited institutions (p<0.05), and the residents at the accredited institutions benefited significantly more from the availability of books and electronic media in gaining theoretical knowledge (p<0.05). When the responses of the residents from accredited and nonaccredited institutions regarding 46 different surgeries were compared, a significant difference was found in 17 of them (p<0.05). There was a significant difference between the averages of residents' responses on the surgical fields they have interest for (p<0.05). It was determined that the residents believed that they could mostly perform surgeries in the fields of trauma, followed by arthroplasty, deformity, arthroscopy, pediatric orthopedics, hand surgery, and spine and tumor surgery. According to their level of seniority, a significant difference was found between the averages of residents' opinions regarding their surgical skill levels (p=0.02). CONCLUSION: We believe that it would be beneficial for the trainers to take necessary precautions to increase the skill levels of the residents of orthopedic surgery. Accreditation significantly contributes to the standardization of education as well as quality improvement. Further action should be taken to increase the number of accredited clinics.

摘要

目的:调查接受培训的骨科与创伤科住院医师在完成专科培训后是否能掌握手术技术,并确定来自获得认证机构和未获得认证机构的住院医师的回答之间是否存在显著差异。 方法:来自伊斯坦布尔省9家机构的131名骨科与创伤科住院医师在上午的培训会议期间回答了问卷。除了基本人口统计学数据、资历水平、设备操作能力以及理论和实践培训外,住院医师还被问及他们认为在专科培训后能够进行何种类型的手术,同时考虑病例的手术和随访情况以及在此期间出现的并发症。住院医师回答了关于创伤、关节镜检查、关节成形术、脊柱、小儿骨科、手外科、畸形以及骨与软组织肿瘤等主要标题下的46种手术的问题。除描述性统计方法外,还使用了单因素方差分析、Tukey多重比较检验和卡方检验来评估数据。结果的显著性水平设定为p<0.05。 结果:共有131名骨科与创伤科住院医师回答了问卷。此外,53名(40.5%)专科学生受雇于获得认证的机构,78名(59.5%)受雇于未获得认证的机构。根据回答,获得认证的机构定期举行的病例汇报、文章撰写会议和省内会议与未获得认证的机构相比存在显著差异(p<0.05),并且获得认证机构的住院医师在通过书籍和电子媒体获取理论知识方面受益显著更多(p<0.05)。当比较来自获得认证和未获得认证机构的住院医师对46种不同手术的回答时,发现其中17种存在显著差异(p<0.05)。住院医师对他们感兴趣的手术领域的回答平均值之间存在显著差异(p<0.05)。确定住院医师认为他们大多能够进行创伤领域的手术,其次是关节成形术、畸形矫正、关节镜检查、小儿骨科、手外科以及脊柱和肿瘤手术。根据他们的资历水平,住院医师对其手术技能水平的看法平均值之间存在显著差异(p = 0.02)。 结论:我们认为培训人员采取必要措施提高骨科住院医师的技能水平将是有益的。认证对教育标准化以及质量提升有显著贡献。应采取进一步行动增加获得认证的诊所数量。

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[1]
Optimizing resident operative self-confidence through competency-based surgical education modules: are we there yet?

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Turk Arch Otorhinolaryngol. 2015-9

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Evaluation of the orthopaedics and traumatology resident education in Turkey: A descriptive study.

Acta Orthop Traumatol Turc. 2016-10

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