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在门诊手术中心开展住院医师教育的障碍和益处的定性研究。

A Qualitative Study of the Barriers and Benefits to Resident Education in Ambulatory Surgical Centers.

机构信息

Johns Hopkins University School of Medicine, Baltimore, Maryland.

Johns Hopkins University School of Medicine, Baltimore, Maryland.

出版信息

J Surg Educ. 2021 Nov-Dec;78(6):1825-1837. doi: 10.1016/j.jsurg.2021.04.002. Epub 2021 Jun 3.

Abstract

OBJECTIVE

As Ambulatory Surgical Centers (ASCs) become more common in academic medical centers, large hospital systems must determine how to shift resident education from inpatient to outpatient surgical centers. This study aims to define stakeholders' views regarding the integration of surgical residents into ASCs.

DESIGN

Long-form interviews lasting 30 to 60 minutes were conducted. Interviews were hand-transcribed and analyzed by qualitative analysis to determine benefits of learning in ASCs for residents, challenges that arise from integrating residents, and recommendations to improve resident incorporation.

SETTING

Interviews were conducted using a video conferencing platform.

PARTICIPANTS

Residency program directors, attending surgeons, graduate medical learners, and a nursing manager were interviewed. Twenty-one total interviews were conducted, representing ten different departments.

RESULTS

Stakeholders agreed that residents benefit from being placed in ASCs because the fast, surgical pace allows the residents to engage in more cases. However, different stakeholders highlighted different challenges, all centered around the notion of inter-stakeholder conflict due to conflicting priorities among residents, attending physicians, and administration. Likewise, recommendations differed by stakeholder group-faculty members sought more defined learning objectives and enhanced communication, whereas residents desired that ambulatory surgical time be more structured.

CONCLUSIONS

Despite the pressures of rapid case turnover, stakeholders agreed that there are many benefits to resident education in ASCs. Findings related to challenges and recommendations support the need to strengthen communication between stakeholder groups and better plan for resident integration into ASCs.

摘要

目的

随着门诊手术中心(ASC)在学术医疗中心变得越来越普遍,大型医院系统必须确定如何将住院医师教育从住院转移到门诊手术中心。本研究旨在确定利益相关者对将外科住院医师纳入 ASC 的看法。

设计

进行了持续 30 至 60 分钟的长格式访谈。访谈内容通过定性分析进行逐字记录和分析,以确定住院医师在 ASC 学习的好处、整合住院医师带来的挑战,以及改善住院医师融入的建议。

地点

访谈通过视频会议平台进行。

参与者

住院医师培训项目主任、主治外科医生、研究生医学学习者和护理经理接受了采访。共进行了 21 次访谈,代表 10 个不同的部门。

结果

利益相关者一致认为,住院医师从被安置在 ASC 中受益,因为快速的手术节奏使住院医师能够参与更多的病例。然而,不同的利益相关者强调了不同的挑战,所有这些都围绕着由于住院医师、主治医生和行政部门之间的优先事项冲突而产生的利益相关者冲突的概念。同样,建议因利益相关者群体而异——教师寻求更明确的学习目标和加强沟通,而住院医师希望门诊手术时间更具结构性。

结论

尽管面临快速病例周转的压力,利益相关者仍一致认为 ASC 对住院医师教育有许多好处。与挑战和建议相关的发现支持加强利益相关者群体之间的沟通以及更好地规划住院医师融入 ASC 的必要性。

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