Colevas Sophia M, Abramson Gwen E D, Jung Sarah A, Elfenbein Dawn M
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
J Surg Res. 2022 Nov;279:557-566. doi: 10.1016/j.jss.2022.06.053. Epub 2022 Jul 31.
As methods of measuring surgical resident competency become more defined, how can faculty know that they are effectively guiding residents toward increasing entrustment? The goal of this study was to use a systematic process to identify effective teaching behaviors, understand discrepancies between learner and teacher perception of behaviors, and provide an insight into areas for improvement in surgical teaching.
A modified Delphi process was used to create a list of critical teaching behaviors for surgical resident education in four domains: Operating Room, Clinic, Inpatient Rounds, and Didactics. Round One surveyed residents and faculty to identify critical teaching behaviors. In Rounds Two and Three, stakeholders narrowed the list to five behaviors in each domain. A needs assessment survey was created and used to identify (1) areas for improvement in residency education and (2) differences in perception of teaching behavior use between faculty and residents.
Eighty one faculty and 56 residents in the Department of Surgery completed the survey. All teaching behaviors in the Operating Room, Clinic, and Rounds domains had a significant difference in response distribution between residents and faculty. Except in Didactics, residents perceived that teaching behaviors were performed less often by attending surgeons than was reported by the faculty members.
A modified Delphi process is an effective way to create a needs assessment survey relating to how surgical education is delivered. Future steps will involve directed interventions aimed at improving the use of certain surgical teaching behaviors in our department.
随着衡量外科住院医师能力的方法日益明确，教员如何才能知道他们正在有效地引导住院医师获得更多的信任呢？本研究的目的是运用系统的方法来确定有效的教学行为，了解学习者与教师对行为认知的差异，并深入了解外科教学中有待改进的方面。
采用改良的德尔菲法，列出外科住院医师教育在四个领域的关键教学行为清单：手术室、诊所、住院查房和教学。第一轮调查了住院医师和教员，以确定关键教学行为。在第二轮和第三轮中，相关人员将每个领域的清单缩小到五项行为。创建了一份需求评估调查问卷，并用于确定（1）住院医师教育中有待改进的方面，以及（2）教员与住院医师在教学行为使用认知上的差异。
外科系的81名教员和56名住院医师完成了调查。手术室、诊所和查房领域的所有教学行为在住院医师和教员的回答分布上存在显著差异。除了教学领域，住院医师认为主刀医生进行教学行为的频率低于教员报告的频率。
改良的德尔菲法是创建与外科教育实施方式相关的需求评估调查问卷的有效方法。未来的步骤将包括针对性的干预措施，旨在改进我们科室某些外科教学行为的使用。
