Discipline of Surgery, The University of Adelaide, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
Research and Evaluation Incorporating ASERNIP-S, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.
Br J Surg. 2021 Oct 23;108(10):1154-1161. doi: 10.1093/bjs/znab283.
The lack of an effective continuing professional development programme for qualified surgeons, specifically one that enhances non-technical skills (NTS), is an issue receiving increased attention. Peer-based coaching, used in multiple professions, is a proposed method to deliver this. The aim of this study was to undertake a systematic review of the literature to summarize the quantity and quality of studies involving surgical coaching of NTS in qualified surgeons.
A systematic search of the literature was performed through MEDLINE, EMBASE, Cochrane Collaboration and PsychINFO. Studies were selected based on predefined inclusion and exclusion criteria. Data for the included studies was independently extracted by two reviewers and the quality of the studies evaluated using the Medical Education and Research Study Quality Instrument (MERSQI).
Some 4319 articles were screened from which 19 met the inclusion criteria. Ten studies involved coaching of individual surgeons and nine looked at group coaching of surgeons as part of a team. Group coaching studies used non-surgeons as coaches, included objective assessment of NTS, and were of a higher quality (average MERSQI 13.58). Individual coaching studies focused on learner perception, used experienced surgeons as coaches and were of a lower quality (average MERSQI 11.58). Individual coaching did not show an objective improvement in NTS for qualified surgeons in any study.
Surgical coaching of qualified surgeons' NTS in a group setting was found to be effective. Coaching of individual surgeons revealed an overall positive learner perception but did not show an objective improvement in NTS for qualified surgeons.
缺乏针对合格外科医生的有效持续专业发展计划，特别是缺乏非技术技能（NTS）的提升计划，这一问题正受到越来越多的关注。同行指导作为一种已应用于多个专业的方法，被提议用于解决这一问题。本研究旨在对文献进行系统综述，以总结涉及合格外科医生 NTS 外科指导的研究的数量和质量。
通过 MEDLINE、EMBASE、Cochrane 协作和 PsychINFO 进行了系统的文献检索。研究根据预先设定的纳入和排除标准进行选择。由两名评审员独立提取纳入研究的数据，并使用医学教育和研究研究质量工具（MERSQI）评估研究质量。
从 4319 篇文章中筛选出 19 篇符合纳入标准的文章。其中 10 项研究涉及对个别外科医生的指导，9 项研究涉及作为团队一部分的外科医生小组指导。小组指导研究使用非外科医生作为指导者，对 NTS 进行客观评估，并且质量更高（平均 MERSQI 为 13.58）。个别指导研究侧重于学习者的感知，使用经验丰富的外科医生作为指导者，且质量较低（平均 MERSQI 为 11.58）。在任何研究中，个别指导都没有显示出对合格外科医生 NTS 的客观改善。
在小组环境中对合格外科医生的 NTS 进行外科指导被发现是有效的。对个别外科医生的指导总体上显示出学习者的积极感知，但没有显示出对合格外科医生 NTS 的客观改善。
