培训外科住院医师的“培训师培训”课程的开发和评估：可行性研究。

The development and evaluation of "Training the trainer" curriculum for surgical residents: Feasibility study.

机构信息

Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, EC1M 6AS, UK Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Garrod Building, Turner St, Whitechapel, London, E1 2AD, UK Princess Royal University Hospital, Farnborough Common, Orpington, BR6 8ND, United Kingdom St George's University Hospitals NHS Foundation Trust, Blackshaw Rd, London, SW17 0QT, United Kingdom Faculty of Medicine, Imperial Collage London St. Mary's Hospital, Paterson Centre, South Wharf Road, Paddington, London, W2 1BL, UK Department of Upper GI & Laparoscopic Surgery, Royal London Hospital, Whitechapel Rd, Whitechapel, London, E1 1FR, UK Department of Upper GI & Laparoscopic Surgery, University College London, 235 Euston Rd, Bloomsbury, London, NW1 2BU, UK Department of Colorectal Surgery, Yeovil District Hospital Foundation Trust, Yeovil, BA21 4AT, Somerset, UK The Griffin Institute, Northwick Park and St Mark's Hospital, Y Block, Watford Rd, Harrow, HA1 3UJ, UK Division of Surgery and Interventional Science, University College London, UK.

出版信息

Int J Surg. 2022 Feb;98:106209. doi: 10.1016/j.ijsu.2021.106209. Epub 2022 Jan 7.

DOI:10.1016/j.ijsu.2021.106209

PMID:35007774

Abstract

BACKGROUND

Over the last decades, there has been greater emphasis on enhancing teaching skills and concepts of Train-The-Trainer (TTT) have been widely adopted across surgical training programs. Current TTT curricula, however, mostly address teaching generic principles without specific guidance on how to teach technical skills among residents. The aim of this proof-of-concept study was to design a bespoke TTT curriculum for surgical technical skills and evaluate its impact.

MATERIAL AND METHODS

A bespoke TTT curriculum was developed to address key teaching surgical skills including a training framework, and performance enhancing feedback. The curriculum was delivered to 41 junior surgical residents in this feasibility study and focused on promoting a training framework including three domains; "set" involving pre-operative preparation, "dialogue" referring to teaching techniques and "closure" covering structured feedback. It was evaluated using Kirkpatrick's model: (i) course feedback; (ii) training quality assessment on a suturing simulated scenario using (a) Competency Assessment Tool (CAT) and a (b) Structured Training Trainer Assessment Report (STTAR) tool; (iii-iv) follow-up survey after one year.

RESULTS

The TTT curriculum was well-perceived, with a median score of 4/5 ("agree") across all components of evaluation forms. The simulated training scenario demonstrated a significant reduction in suturing errors following delivery of training (pre-TTT [4.25; IQR:4.42]; post-TTT [2.34; IQR:2.38], p-value = 0.014). Improvement in teaching was also noted and reflected in 'Set' (pre-TTT [3.50; IQR: 3.00] and post-TTT [5.00; IQR: 0.00], p-value = 0.019) and 'Closure' (pre-TTT [4.75; IQR: 1.88] and post-TTT [5.00; IQR: 0.00], p value = 0.007). 25% of participants contributed to the long-term survey highlighting that most practiced skills within 6 months of the curriculum with positive feedback from their learners.

CONCLUSION

This proof-of-concept study confirms the feasibility and acceptability of delivering a bespoke Train-The-Trainer curriculum to surgical residents. It provides a structured training framework that can enhance teaching technical skills.

摘要

背景

在过去的几十年中，人们越来越重视提高教学技能，并且“培训师培训”（TTT）的理念已经在外科培训计划中得到广泛应用。然而，目前的 TTT 课程主要涉及通用教学原则，而没有针对住院医师的技术技能教学提供具体指导。本概念验证研究的目的是设计一个专门的外科技术技能 TTT 课程，并评估其效果。

材料与方法

本研究设计了一个专门的 TTT 课程，以解决关键的教学技能，包括培训框架和促进绩效的反馈。在这项可行性研究中，该课程向 41 名初级外科住院医师进行了传授，并侧重于促进包括三个领域的培训框架；“设置”涉及术前准备，“对话”是指教学技巧，“结束”是指结构化反馈。该课程使用 Kirkpatrick 模型进行了评估：（i）课程反馈；（ii）使用（a）能力评估工具（CAT）和（b）结构化培训培训师评估报告（STTAR）工具在缝合模拟场景中进行培训质量评估；（iii-iv）一年后的后续调查。

结果

TTT 课程的评价良好，所有评估表的评分均为中位数 4/5（“同意”）。在培训后，缝合模拟训练场景中的缝合错误明显减少（培训前 TTT [4.25; IQR：4.42]；培训后 TTT [2.34; IQR：2.38]，p 值=0.014）。“设置”（培训前 TTT [3.50; IQR：3.00]和培训后 TTT [5.00; IQR：0.00]，p 值=0.019）和“结束”（培训前 TTT [4.75; IQR：1.88]和培训后 TTT [5.00; IQR：0.00]，p 值=0.007）的教学也得到了改善，这也反映了教学的改善。25%的参与者参与了长期调查，突出表明大多数参与者在课程结束后的 6 个月内都实践了技能，并收到了学习者的积极反馈。