Department of Surgery, University of Melbourne, Victoria, Australia; Department of General Surgical Specialties, Royal Melbourne Hospital, Victoria, Australia.
Department of General Surgical Specialties, Royal Melbourne Hospital, Victoria, Australia; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Victoria, Australia; Department of Surgery, University of Auckland, New Zealand.
J Surg Educ. 2021 Jul-Aug;78(4):1227-1235. doi: 10.1016/j.jsurg.2020.11.007. Epub 2020 Nov 24.
The operating theatre (OT) is an important learning environment. Trainees face barriers to learning in the OT that may reduce meaningful educational interactions. The impact of these barriers on the intraoperative learning experience of trainees and the strategies that they employ to overcome them are not known. This qualitative study aimed to describe the intraoperative learning experiences of senior general surgery trainees in Australia and their strategies to optimize learning in the OT.
DESIGN, SETTING, PARTICIPANTS: The authors developed a semi-structured interview guide based on published literature. Purposive sampling was used to identify a representative group of general surgery trainees in Australia, who were interviewed in a private setting with audio recordings deidentified for verbatim transcription and analysis. Thematic analysis was conducted using an interpretivist approach to produce a coding framework.
Ten trainees participated in the study. Themes were divided into external and internal barriers to learning, promoters of effective learning and actions to facilitate learning. External barriers included cultural neglect of an important issue, with inadequate prioritization of teaching and a lack of structure for intraoperative learning. From this, we identified the theme of missed opportunities. Internal barriers included difficulties in developing assertiveness required to address these issues and a failure to adequately plan for learning, with reliance on the mentor to initiate. Actions to facilitate learning were rarely employed by trainees, as most were unaware of strategies to maximize intraoperative learning.
Trainees find the barriers to learning in the OT difficult to address and are not well acquainted with strategies that may allow them to maximize their learning.
手术室（OT）是一个重要的学习环境。受训者在手术室中面临着学习障碍，这可能会减少有意义的教育互动。这些障碍对受训者在手术室内的学习体验的影响，以及他们用来克服这些障碍的策略，目前还不得而知。本定性研究旨在描述澳大利亚高级普通外科受训者在手术室内的学习体验，以及他们优化手术室学习的策略。
设计、设置、参与者：作者根据已发表的文献制定了一份半结构化访谈指南。采用目的性抽样方法，在私人环境中对澳大利亚的普通外科受训者进行了代表性的小组访谈，并对访谈进行了录音，对音频记录进行去识别，以便进行逐字转录和分析。采用解释主义方法进行主题分析，以生成编码框架。
10 名受训者参与了研究。主题分为学习的外部和内部障碍、有效学习的促进因素以及促进学习的行动。外部障碍包括对一个重要问题的文化忽视，教学没有得到足够的重视，以及手术室内学习缺乏结构。由此，我们确定了错失机会的主题。内部障碍包括发展解决这些问题所需的自信的困难，以及未能充分计划学习，依赖导师来发起。促进学习的行动很少被受训者采用，因为大多数人都不知道最大限度地提高手术室内学习的策略。
受训者发现手术室中的学习障碍难以解决，并且不熟悉可能使他们最大限度地学习的策略。
