Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, GRB-425, Boston, MA, 02114, USA.
Ariadne Labs, Harvard T.H. Chan School of Public Health, Brigham and Women's Hospital, 401 Park Drive, 3rd Floor West, Boston, MA, 02215, USA.
World J Surg. 2020 Sep;44(9):2857-2868. doi: 10.1007/s00268-020-05518-x.
The Surgical Safety Checklist (SSC) has been shown to reduce perioperative complications across global health systems. We sought to assess perceptions of the SSC and suggestions for its improvement among medical students, trainees, and early career providers.
From July to September 2019, a survey assessing perceptions of the SSC was disseminated through InciSioN, the International Student Surgical Network comprising medical students, trainees, and early career providers pursuing surgery. Individuals with ≥2 years of independent practice after training were excluded. Respondents were categorized according to any clinical versus solely non-clinical SSC exposure. Logistic regression was used to evaluate associations between clinical/non-clinical exposure and promoting future use of the SSC, adjusting for potential confounders/mediators: training level, human development index, and first perceptions of the SSC. Thematic analysis was conducted on suggestions for SSC improvement.
Respondent participation rate was 24%. Three hundred and eighteen respondents were included in final analyses; 215 (67%) reported clinical exposure and 190 (60%) were promoters of future SSC use. Clinical exposure was associated with greater odds of promoting future SSC use (aOR 1.81 95% CI [1.03-3.19], p = 0.039). A greater proportion of promoters reported "Improved Operating Room Communication" as a goal of the SSC (0.21 95% CI [0.15-0.27]-vs.-0.12 [0.06-0.17], p = 0.031), while non-promoters reported the SSC goals were "Not Well Understood" (0.08 95% CI [0.03-0.12]-vs.-0.03 [0.01-0.05], p = 0.032). Suggestions for SSC improvement emphasized context-specific adaptability and earlier formal training.
Clinical exposure to the SSC was associated with promoting its future use. Earlier formal clinical training may improve perceptions and future use among medical students, trainees, and early career providers.
手术安全检查表（SSC）已被证明可减少全球卫生系统的围手术期并发症。我们旨在评估医学生、住院医师和早期职业提供者对 SSC 的看法以及对其改进的建议。
2019 年 7 月至 9 月，通过包含医学生、住院医师和早期职业外科医生的国际学生外科网络 InciSioN ，分发了一项评估 SSC 认知的调查。排除了在培训后有 2 年以上独立实践经验的个人。根据任何临床与仅非临床 SSC 暴露，将受访者分为两类。使用逻辑回归评估临床/非临床暴露与促进未来使用 SSC 之间的关联，同时调整潜在的混杂因素/调解因素：培训水平、人类发展指数和对 SSC 的第一印象。对 SSC 改进的建议进行了主题分析。
应答者参与率为 24%。最终分析包括 318 名应答者；215 名（67%）报告了临床暴露，190 名（60%）是未来 SSC 使用的推动者。临床暴露与更大的促进未来 SSC 使用的可能性相关（aOR 1.81，95%CI [1.03-3.19]，p=0.039）。更多的支持者报告说 SSC 的目标是“改善手术室沟通”（0.21，95%CI [0.15-0.27]-与 0.12 [0.06-0.17]，p=0.031），而非支持者则报告 SSC 的目标是“不太理解”（0.08，95%CI [0.03-0.12]-与 0.03 [0.01-0.05]，p=0.032）。对 SSC 改进的建议强调了具体情况的适应性和更早的正式培训。
临床接触 SSC 与促进其未来使用有关。更早的正式临床培训可能会改善医学生、住院医师和早期职业提供者对 SSC 的看法和未来使用。
