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最大化手术室学习:住院医师的观点。

Maximizing Learning in the Operating Room: Residents' Perspectives.

机构信息

Department of Surgery, University of Vermont Medical Center, Burlington, Vermont.

Department of Surgery, University of Vermont Medical Center, Burlington, Vermont.

出版信息

J Surg Res. 2021 Jul;263:5-13. doi: 10.1016/j.jss.2021.01.013. Epub 2021 Feb 19.

Abstract

BACKGROUND

Few studies examine how residents can optimize their educational experience in the OR on their terms. This study aimed to examine residents' perceptions of how learners can maximize their education in the OR.

METHOD

Using constructivist grounded theory methodology, the authors conducted focus groups with general surgery residents, PGY1-5, followed by semi-structured interviews with attending surgeons from a single, academic medical center. Constant comparison was used to identify themes and explore their relationships. Theoretical sampling was used until saturation was achieved.

RESULTS

Residents and attendings participated. Two phases of OR learning were identified, intra-operative and inter-operative. Characters that made optimized learning included control, struggling, and reflection. Residents who practiced self-reflection with their experiences, and were able to articulate this awareness to attendings, felt the OR was an ideal learning environment. Attendings echoed similar findings.

CONCLUSIONS

Providing residents with a method of maximizing OR learning is critical to postgraduate clinical education. Currently, observation passively morphs into active learning and eventually independent operating in the OR. However, residents who practice self-regulated learning, and are able to discuss their educational goals with attendings, seem to find the OR a better learning environment and progress to independence more quickly. This was echoed by practicing attendings. Providing residents with a generalizable, self-regulated learning framework specific to operative educational experiences could maximize learning potential and expedite resident progression in the OR.

摘要

背景

很少有研究探讨住院医师如何根据自己的条件优化他们在手术室的教育体验。本研究旨在探讨住院医师对学习者如何最大限度地在手术室接受教育的看法。

方法

使用建构主义扎根理论方法,作者对普外科住院医师(PGY1-5)进行了焦点小组讨论,随后对来自一家学术医学中心的主治外科医生进行了半结构化访谈。使用恒定性比较来确定主题并探索它们之间的关系。使用理论抽样直到达到饱和。

结果

住院医师和主治外科医生参与了研究。确定了手术室学习的两个阶段,即手术内和手术间。使优化学习成为可能的特征包括控制、挣扎和反思。那些通过经验进行自我反思并能够向主治外科医生表达这种意识的住院医师认为手术室是一个理想的学习环境。主治外科医生也对此表示赞同。

结论

为住院医师提供最大限度地学习手术室的方法对于研究生临床教育至关重要。目前,观察被动地转变为手术室中的主动学习,最终转变为独立操作。然而,那些进行自我调节学习并能够与主治外科医生讨论其教育目标的住院医师似乎发现手术室是一个更好的学习环境,并能更快地独立。这也得到了主治外科医生的回应。为住院医师提供一种针对手术教育经验的可推广的自我调节学习框架,可以最大限度地提高学习潜力,并加快住院医师在手术室中的进展。

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