Sandhu Gurjit, Thompson-Burdine Julie, Dombrowski Janet, Sutzko Danielle C, Nikolian Vahagn C, Boniakowski Anna, Georgoff Patrick E, Matusko Niki, Prabhu Kaustubh, Minter Rebecca M
Department of Surgery, University of Michigan, Ann Arbor, MI.
Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI.
Ann Surg. 2021 Jun 1;273(6):e255-e261. doi: 10.1097/SLA.0000000000003436.
The purpose of this study was to measure the efficacy of a novel faculty and resident educational bundle focused on development of faculty-resident behaviors and entrustment in the operating room.
As surgical training environments are orienting to entrustable professional activities (EPAs), successful transitions to this model will require significant faculty and resident development. Identifying an effective educational initiative which prepares faculty and residents for optimizing assessment, teaching, learning, and interacting in this model is critical.
From September 2015 to June 2017, an experimental study was conducted in the Department of Surgery at the University of Michigan Health System (UMHS). Case observations took place across general, plastic, thoracic, and vascular surgical specialties. A total of 117 operating room observations were conducted during Phase I of the study and 108 operating room observations were conducted during Phase II following the educational intervention. Entrustment behaviors were rated for 56 faculty and 73 resident participants using OpTrust, a validated intraoperative entrustment instrument.
Multiple regression analysis showed a significant increase in faculty entrustment (Phase I = 2.32 vs Phase II = 2.56, P < 0.027) and resident entrustability (Phase I = 2.16 vs Phase II = 2.40, P < 0.029) scores following exposure to the educational intervention.
Our study shows improved intraoperative entrustment following implementation of faculty and resident development, indicating the efficacy of this innovative educational bundle. This represents a crucial component in the implementation of a competency-based assessment framework like EPAs.
本研究旨在衡量一种新型的教师和住院医师教育包的效果，该教育包专注于培养教师 - 住院医师行为以及手术室中的委托能力。
随着外科培训环境向可委托专业活动（EPA）转变，成功过渡到这种模式将需要教师和住院医师的显著发展。确定一项有效的教育举措，使教师和住院医师为在该模式下优化评估、教学、学习和互动做好准备至关重要。
2015年9月至2017年6月，在密歇根大学健康系统（UMHS）外科进行了一项实验研究。病例观察涵盖普通外科、整形外科、胸外科和血管外科专业。在研究的第一阶段共进行了117次手术室观察，在教育干预后的第二阶段进行了108次手术室观察。使用OpTrust（一种经过验证的术中委托工具）对56名教师和73名住院医师参与者的委托行为进行评分。
多元回归分析显示，在接受教育干预后，教师委托能力得分（第一阶段 = 2.32，第二阶段 = 2.56，P < 0.027）和住院医师可委托性得分（第一阶段 = 2.16，第二阶段 = 2.40，P < 0.029）显著提高。
我们的研究表明，在实施教师和住院医师发展计划后，术中委托能力有所提高，表明这种创新教育包的有效性。这是实施像EPA这样基于能力的评估框架的关键组成部分。
