Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, Bronx, New York (Drs. Gressel and Banks).
Department of Obstetrics & Gynecology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia (Dr. George).
J Minim Invasive Gynecol. 2021 Nov;28(11):1882-1888.e5. doi: 10.1016/j.jmig.2021.04.019. Epub 2021 May 5.
To compare residents' perceptions of readiness to perform robotic-assisted laparoscopic hysterectomy with the perceptions of residency program directors in obstetrics and gynecology programs throughout the United States.
A survey was administered to all residents taking the 2019 Council on Resident Education in Obstetrics and Gynecology Exam and concurrently to program directors in all Accreditation Council for Graduate Medical Education-accredited training programs.
The survey was designed to assess resident confidence to perform robotic hysterectomies by the time of graduation.
No patients were included in the study.
The only intervention was administration of the survey.
De-identified survey data were analyzed using chi-squared and Fisher's exact tests. A total of 5473 resident respondents and 241 residency program directors were included in the study. Fifty-two percent of graduating residents reported that they felt they were given surgical autonomy to perform robotic hysterectomies, and 53.7% reported that they could perform one independently (if it was an "emergency" and they had to). By the time of graduation, only 59% of residents reported confidence performing a robotic hysterectomy, and only 56% reported they felt that it would be an important procedure for their future career. Program directors were significantly more likely to report that their residents were given autonomy to perform robotic hysterectomy by graduation (61.0% [95% confidence interval (CI), 54.3-67.3]), could perform a robotic hysterectomy independently (60.9% [95% CI, 53.9-67.6]), or could perform a robotic hysterectomy by graduation (70.2% [95% CI, 63.5-76.3]) than residents themselves (38.6% [95% CI, 37.2-40.0], 22.8% [95% CI, 21.6-24.0], 62.6% [95% CI, 61.2-64.0], respectively).
At the time of graduation, residents' confidence in performing robotic hysterectomy independently is lower than their confidence in performing all other approaches to hysterectomy.
比较美国各地妇产科住院医师培训项目主任对住院医师进行机器人辅助腹腔镜子宫切除术准备情况的看法。
向参加 2019 年妇产科住院医师教育委员会考试的所有住院医师和所有经研究生医学教育认证委员会认证的培训项目主任发放调查问卷。
该调查旨在评估住院医师在毕业时进行机器人子宫切除术的信心。
本研究未纳入患者。
唯一的干预措施是进行调查。
使用卡方检验和 Fisher 确切检验对匿名调查数据进行分析。共纳入 5473 名住院医师和 241 名住院医师培训项目主任。52%的即将毕业的住院医师报告称,他们感到自己有进行机器人子宫切除术的手术自主权,53.7%的住院医师报告称,如果是紧急情况且必须进行手术,他们可以独立进行该手术。到毕业时,只有 59%的住院医师报告对进行机器人子宫切除术有信心,只有 56%的住院医师报告他们认为这对他们未来的职业生涯很重要。项目主任报告称,他们的住院医师在毕业时被赋予进行机器人子宫切除术自主权(61.0%[95%置信区间(CI):54.3-67.3])、可以独立进行机器人子宫切除术(60.9%[95% CI:53.9-67.6])或可以在毕业时进行机器人子宫切除术(70.2%[95% CI:63.5-76.3])的比例明显高于住院医师本人(分别为 38.6%[95% CI:37.2-40.0]、22.8%[95% CI:21.6-24.0]、62.6%[95% CI:61.2-64.0])。
在毕业时,住院医师独立进行机器人子宫切除术的信心低于他们对所有其他子宫切除术方法的信心。