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教育发病率和死亡率:恢复术中教学和学习。

Education Morbidity and Mortality: Reviving Intraoperative Teaching and Learning.

机构信息

Ohio State University Wexner Medical Center, Columbus, Ohio.

Ohio State University Wexner Medical Center, Columbus, Ohio.

出版信息

J Surg Res. 2021 Aug;264:462-468. doi: 10.1016/j.jss.2021.02.044. Epub 2021 Apr 10.

Abstract

BACKGROUND

Using the platform of morbidity and mortality conference, we developed and executed a combined faculty-resident intervention called "Education M&M" to discuss challenges faced by both parties in the operating room (OR), identify realistic solutions, and implement action plans. This study aimed to investigate the impact of this intervention on resident OR training.

MATERIALS AND METHODS

Two resident case presentations were followed by audience discussion and recommendations regarding actionable solutions aimed at improving resident OR training from an expert faculty panel. Postintervention surveys were completed by participants immediately and 2 mo later to assess perceived short and long-term impact on OR teaching and/or learning and the execution of two recommended solutions. Descriptive statistical analysis was applied.

RESULTS

Immediate post-intervention surveys (n = 44) indicated that 81.8% of participants enjoyed the M&M "a lot"; 90.1% said they would use some or a lot of the ideas presented. Awareness of OR teaching/learning challenges before and after the M&M improved from 3.0 to 3.7 (P = 0.00001) for faculty and 3.0 to 3.9 for trainees (P = 0.00004). Understanding of OR teaching and/or learning approaches improved from 3.1 to 3.7 for faculty (P = 0.00004) and 2.7 to 3.9 for trainees (P = 0.00001). In 2-mo post-intervention surveys, most residents had experienced two recommended solutions (71% and 88%) in the OR, but self-reported changes to faculty behavior did not reach statistical significance.

CONCLUSIONS

A department-wide education M&M could be an effective approach to enhance mutual communication between faculty members and residents around OR teaching/learning by identifying program-specific challenges and potential actionable solutions.

摘要

背景

我们利用发病率和死亡率会议的平台,开发并执行了一项联合住院医师和主治医生干预措施,称为“教育发病率和死亡率”,以讨论双方在手术室(OR)中面临的挑战,确定切实可行的解决方案,并实施行动计划。本研究旨在调查该干预措施对住院医师 OR 培训的影响。

材料和方法

两名住院医师病例介绍后,由观众讨论,并根据专家主治医生小组提出的切实可行的解决方案提出建议,旨在改善住院医师 OR 培训。参与者在干预后立即和 2 个月后完成了后续调查,以评估对 OR 教学和/或学习以及执行两项推荐解决方案的短期和长期影响。应用描述性统计分析。

结果

即时干预后调查(n=44)表明,81.8%的参与者非常喜欢 M&M;90.1%的人表示他们会使用一些或大部分提出的想法。干预前后,教职员工对 OR 教学/学习挑战的认识从 3.0 提高到 3.7(P=0.00001),住院医师从 3.0 提高到 3.9(P=0.00004)。教职员工对 OR 教学和/或学习方法的理解从 3.1 提高到 3.7(P=0.00004),住院医师从 2.7 提高到 3.9(P=0.00001)。在 2 个月的干预后调查中,大多数住院医师在 OR 中经历了两项推荐的解决方案(71%和 88%),但教职员工行为的自我报告变化没有达到统计学意义。

结论

一项全部门的教育 M&M 可能是一种有效的方法,可以通过确定特定于计划的挑战和潜在的可行解决方案,增强教职员工和住院医师之间在 OR 教学/学习方面的相互沟通。

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