神经外科住院医师研究教育：对美国住院医师培训项目主任的一项调查。

Neurosurgical resident research education: a survey of United States residency program directors.

作者信息

Lepard Jacob R, Shank Christopher D, Agee Bonita S, Hadley Mark N, Walters Beverly C

出版信息

J Neurosurg. 2019 Oct 25;133(5):1527-1536. doi: 10.3171/2019.7.JNS19632. Print 2020 Nov 1.

DOI:10.3171/2019.7.JNS19632

PMID:32508079

Abstract

OBJECTIVE

The application of evidence-based medicine (EBM) has played an increasing role within neurosurgical education over the last several decades. The Accreditation Council for Graduate Medical Education (ACGME) has mandated that residents are now required to demonstrate academic productivity and mastery of EBM principles. The goal of this study was to assess how neurosurgery programs around the US are dealing with the challenges of fulfilling these program requirements from the ACGME in addition to standard neurosurgical education.

METHODS

A 20-question survey was developed and electronically delivered to residency program directors of the 110 ACGME-approved MD and DO training programs in the US. Data regarding journal club and critical appraisal skills, research requirements, and protected research time were collected. Linear regression was used to determine significant associations between these data and reported resident academic productivity.

RESULTS

Responses were received from 102 of the 110 (92.7%) neurosurgical training programs in the US. Ninety-eight programs (96.1%) confirmed a regularly scheduled journal club. Approximately half of programs (51.5%) indicated that the primary goal of their journal club was to promote critical appraisal skills. Only 58.4% of programs reported a formal EBM curriculum. In 57.4% of programs an annual resident publication requirement was confirmed. Multivariate regression models demonstrated that greater protected research time (p = 0.001), journal club facilitator with extensive training in research methods (p = 0.029), and earlier research participation during residency (p = 0.049) all increased the number of reported publications per resident.

CONCLUSIONS

Although specific measures are important, and should be tailored to the program, the overall training culture with faculty mentorship and provision of time and resources for research activity are probably the most important factors.

摘要

目的

在过去几十年里，循证医学（EBM）的应用在神经外科教育中发挥着越来越重要的作用。毕业后医学教育认证委员会（ACGME）规定，住院医师现在需要展现学术产出以及对循证医学原则的掌握。本研究的目的是评估美国各地的神经外科项目如何应对除标准神经外科教育外，满足ACGME这些项目要求所带来的挑战。

方法

设计了一份包含20个问题的调查问卷，并以电子方式发送给美国110个经ACGME批准的医学博士和医学博士培训项目的住院医师项目主任。收集了有关文献研讨课和批判性评价技能、研究要求以及受保护研究时间的数据。使用线性回归来确定这些数据与报告的住院医师学术产出之间的显著关联。

结果

美国110个神经外科培训项目中有102个（92.7%）回复了问卷。98个项目（96.1%）确认有定期安排的文献研讨课。大约一半的项目（51.5%）表示其文献研讨课的主要目标是提高批判性评价技能。只有58.4%的项目报告有正式的循证医学课程。57.4%的项目确认有年度住院医师发表要求。多变量回归模型表明，更多的受保护研究时间（p = 0.001）、在研究方法方面接受过广泛培训的文献研讨课主持人（p = 0.029）以及住院医师期间更早参与研究（p = 0.049），均增加了每位住院医师报告的发表数量。