颈清扫术手术能力评估：一项试点研究。
Assessment of surgical competence for neck dissection: a pilot study.
机构信息
From the Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Que. (Mercier, Guertin, Bissada, Christopoulos, Tabet, Yang, Ayad); the Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Que. (Christopoulos, Ayad); and the Hôpital Maisonneuve-Rosemont, Montréal, Que. (Olivier, Ayad).
From the Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Que. (Mercier, Guertin, Bissada, Christopoulos, Tabet, Yang, Ayad); the Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Que. (Christopoulos, Ayad); and the Hôpital Maisonneuve-Rosemont, Montréal, Que. (Olivier, Ayad)
出版信息
Can J Surg. 2022 Mar 9;65(2):E178-E187. doi: 10.1503/cjs.018020. Print 2022 Mar-Apr.
BACKGROUND
Progressive implementation of the milestone competence-based curriculum has created a need for new objective and validated means to assess resident surgical proficiency. A previous systematic review of the literature by our group has highlighted a shortage of tools assessing surgical competence in oncologic procedures in otolaryngology - head and neck surgery.
METHODS
We developed a procedure-specific assessment tool for neck dissection using a modified Delphi method. The 2-part design was modelled on the previously validated Objective Structured Assessment of Technical Skills checklist. The tool was then validated through a 1-year multicentric prospective study in collaboration with the residents and faculty from our academic centre. Additionally, we developed an online survey to assess the acceptability by residents and staff before and after the validation studies.
RESULTS
A total of 29 evaluations were completed throughout the 2016-2017 academic year. Acceptability ranked high for both residents and staff, with a single discrepancy in responses regarding a potential formative as opposed to summative use of the tool. Validation study results showed significantly higher checklist scores among senior residents than junior residents, as well as a significant score progression over time ( < 0.05). Trends in scores on the task-specific tool correlated highly to results obtained on a validated global rating scale ( < 0.05).
CONCLUSION
The first tool assessing surgical competence in oncologic otolaryngology - head and neck surgery has been developed and shows promising validity.
背景
里程碑式基于能力的课程的逐步实施，需要新的客观和经过验证的方法来评估住院医师的手术熟练程度。我们小组之前对文献的系统回顾强调了缺乏评估耳鼻喉科 - 头颈外科肿瘤手术技能的工具。
方法
我们使用改良 Delphi 法开发了一种用于颈部解剖的特定程序评估工具。该 2 部分设计基于之前经过验证的客观结构化评估技术技能检查表。然后，通过与我们学术中心的住院医师和教师合作进行为期 1 年的多中心前瞻性研究对该工具进行了验证。此外，我们在验证研究之前和之后开发了一个在线调查，以评估住院医师和工作人员的可接受性。
结果
在 2016-2017 学年共完成了 29 次评估。住院医师和工作人员对工具的可接受性评价很高，只有一次对工具的潜在形成性与总结性使用存在分歧。验证研究结果表明，高级住院医师的检查表评分明显高于初级住院医师，并且随着时间的推移评分呈显著上升趋势（<0.05）。特定任务工具上的得分趋势与经过验证的总体评分量表上的结果高度相关（<0.05）。
结论
已经开发出第一个评估耳鼻喉科 - 头颈外科肿瘤手术技能的工具，并且显示出有希望的有效性。
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