Division of Plastic Surgery, Department of Surgery, University of California San Francisco, San Francisco, California.
Division of Education, American College of Surgeons, Chicago, Illinois; Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
J Surg Educ. 2022 Sep-Oct;79(5):1124-1131. doi: 10.1016/j.jsurg.2022.04.011. Epub 2022 Jun 9.
To establish expert consensus regarding the domains and topics for senior surgery residents (PGY-4) to make critical decisions and assume senior-level responsibilities, and to develop the formative American College of Surgeons Senior Resident Readiness Assessment (ACS SRRA) Program.
The American College of Surgeons (ACS) education leadership team conducted a focus group with surgical experts to identify the content for an assessment tool to evaluate senior residents' readiness for their increased levels of responsibility. After the focus group, national experts were recruited to develop consensus on the topics through three rounds of surveys using Delphi methodology. The Delphi participants rated topics using Likert-type scales and their comments were incorporated into subsequent rounds. Consensus was defined as ≥ 80% agreement with internal-consistency reliability (Cronbach's alpha) ≥ 0.8. In a stepwise fashion, topics that did not achieve consensus for inclusion were removed from subsequent survey rounds.
The surveys were administered via an online questionnaire.
Twelve program directors and assistant program directors made up the focus group. The 39 Delphi participants represented seven different surgical subspecialties and were from diverse practice settings. The median length of experience in general surgery resident education was 20 years (IQR 14.3-30.0) with 64% of the experts being either current or past general surgery residency program directors.
The response rate was 100% and Cronbach's alpha was ≥ 0.9 for each round. The Delphi participants contributed a large number of comments. Of the 201 topics that were evaluated initially, 120 topics in 25 core clinical areas were included to create the final domains of ACS SRRA.
National consensus on the domain of the ACS SRRA has been achieved via the modified Delphi method among expert surgeon educators. ACS SRRA will identify clinical topics and areas in which each senior resident needs improvement and provide data to residents and residency programs to develop individualized learning plans. This would help in preparing the senior residents to assume their responsibilities and support their readiness for future fellowship training or surgical practice.
就外科住院医师 4 年级（PGY-4）做出关键决策和承担高级责任的领域和主题达成专家共识，并制定形成性美国外科医师学院高级住院医师准备情况评估（ACS SRRA）计划。
美国外科医师学院（ACS）教育领导团队与外科专家进行了焦点小组讨论，以确定评估工具的内容，以评估高级住院医师承担其增加的责任的准备情况。在焦点小组讨论之后，招募了全国专家通过使用 Delphi 方法进行三轮调查来就主题达成共识。Delphi 参与者使用李克特量表对主题进行评分，并将他们的意见纳入后续轮次。共识定义为 ≥80%的同意和内部一致性可靠性（Cronbach's alpha）≥0.8。以逐步的方式，未达成共识纳入的主题将从后续调查轮次中删除。
通过在线问卷进行调查。
12 名项目主任和助理项目主任组成了焦点小组。39 名 Delphi 参与者代表了七个不同的外科专业，来自不同的实践环境。在普通外科住院医师教育方面的平均经验长度为 20 年（IQR 14.3-30.0），其中 64%的专家是现任或过去的普通外科住院医师项目主任。
响应率为 100%，并且每个轮次的 Cronbach's alpha 均≥0.9。Delphi 参与者提出了大量意见。在最初评估的 201 个主题中，25 个核心临床领域中的 120 个主题被包括在内，以创建 ACS SRRA 的最终领域。
通过专家外科教育家之间的修改后的 Delphi 方法，就 ACS SRRA 的领域达成了全国共识。ACS SRRA 将确定每个高级住院医师需要改进的临床主题和领域，并为住院医师和住院医师计划提供数据，以制定个性化的学习计划。这将有助于为高级住院医师承担责任和为未来的奖学金培训或外科实践做好准备。
