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外科住院医师在手术室中获取手术技能的挑战:一项定性研究。

Surgical residents' challenges with the acquisition of surgical skills in operating rooms: A qualitative study.

作者信息

Sadati Leila, Yazdani Shahram, Heidarpoor Peigham

机构信息

Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Medical Education, Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Adv Med Educ Prof. 2021 Jan;9(1):34-43. doi: 10.30476/jamp.2020.87464.1308.

Abstract

INTRODUCTION

Training in operating rooms is challenging. Specifically, surgical residents often experience a stressful environment in training arenas that, in turn, might affect their ability in the acquisition of the required qualifications. This study aims at the qualitative explanation of how the surgical residents acquire the surgical skills in operating rooms.

METHODS

This qualitative study was conducted in 2019-2020 using the conventional content analysis method. Participants were selected using purposive sampling. Data were collected through 25 semi-structured in-depth interviews. Then, the interview transcriptions were analyzed in MaxQDA2 software using the content analysis method.

RESULTS

The data were classified into two main categories, namely challenges/obstacles and strategies for dealing with the challenges. The data in the first category were further classified into four subcategories, including burnout, confusion in technique selection, unequal learning opportunities, ignorance, and responsibility misassignment. Similarly, four subcategories of establishing communication channels with chief residents and faculty members, learning by the non-surgeon pathway, covert progress in the learning path, and taking advantage of force from a position of power in the learning path were considered for the second category.

CONCLUSION

Based on the findings of the study, surgical residents face serious challenges and obstacles in their training course. To address these challenges, the curriculum of the surgical course needs to be improved with the emphasis on the balanced responsibility assignment and enhanced human communication.

摘要

引言

手术室培训具有挑战性。具体而言,外科住院医师在培训环境中常常面临压力,这反过来可能会影响他们获得所需资质的能力。本研究旨在定性解释外科住院医师如何在手术室中获得手术技能。

方法

本定性研究于2019 - 2020年采用传统内容分析法进行。通过目的抽样选择参与者。通过25次半结构化深度访谈收集数据。然后,使用内容分析法在MaxQDA2软件中对访谈转录本进行分析。

结果

数据分为两大类,即挑战/障碍和应对挑战的策略。第一类数据进一步分为四个子类别,包括职业倦怠、技术选择困惑、学习机会不平等、忽视和责任分配不当。同样,第二类考虑了与上级住院医师和教员建立沟通渠道、通过非外科途径学习、学习过程中的隐性进步以及在学习过程中利用权力地位的力量这四个子类别。

结论

基于该研究结果,外科住院医师在培训过程中面临严峻挑战和障碍。为应对这些挑战,外科课程的设置需要改进,重点是平衡责任分配和加强人际沟通。

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