Department of Surgery, University Hospital Waterford, Waterford, Ireland.
Division of Traumatology, Surgical Critical Care and Emergency Surgery, Penn Medicine, Philadelphia, PA, USA.
Ir J Med Sci. 2023 Jun;192(3):1303-1309. doi: 10.1007/s11845-022-03117-4. Epub 2022 Aug 15.
The current sparsity of surgical trainees' exposure to training in operative trauma surgery is multifactorial. This concern has been addressed in the revised Intercollegiate Surgical Curriculum Programme (ISCP) for general and vascular surgery (2021). In the lead up to its implementation, we aimed to assess both trainee and consultant confidence levels as a surrogate reflection in the core competency operative skills in general emergency trauma surgery, identify individual experience in commonly performed trauma procedures and gauge interest in a career in trauma surgery.
An online survey was circulated to general surgery and vascular surgery trainees and consultants. Self-reported competencies were assessed using a 1-10 confidence rating scale. Most questions were based on competencies in emergency trauma surgery as set out by the ISCP.
Out of 251 surgical trainees and consultants, 119 responded to our survey (47.4% response rate). Less than half (44.1%; n = 52) of respondents had experienced a trauma thoracotomy. Respondents scored 'somewhat' or 'not at all' competent in the majority of competencies assessed.
Self-reported competencies in operative trauma skills across all subgroups were sub-standard with incremental levels of perceived competence proportional to years of surgical training. Our data supports the necessity of the new curriculum, in addition to modern training pathways with direct exposure to operative trauma surgery involving dedicated trauma centres and networks, and responsibility of training pathways in the provision of training trauma surgery.
目前，外科受训者在创伤手术培训方面的接触机会很少，这是多方面的原因造成的。这一问题已经在 2021 年修订的普通外科和血管外科联合外科课程计划（ISCP）中得到解决。在实施之前，我们旨在评估学员和顾问的信心水平，作为对普通急诊创伤手术核心能力手术技能的替代反映，确定在常见创伤手术程序方面的个人经验，并衡量对创伤外科职业的兴趣。
我们向普通外科和血管外科的受训者和顾问发放了在线调查。使用 1-10 的信心评分量表评估自我报告的能力。大多数问题都是基于 ISCP 规定的急诊创伤手术能力。
在 251 名外科受训者和顾问中，有 119 人回应了我们的调查（47.4%的回应率）。只有不到一半（44.1%；n=52）的受访者经历过创伤性开胸术。受访者对评估的大多数能力的评价是“有些”或“完全没有”胜任。
所有亚组的手术创伤技能自我报告能力都不达标，随着手术培训年限的增加，感知能力的水平也逐渐提高。我们的数据支持新课程的必要性，以及现代培训途径，包括直接接触专门的创伤中心和网络进行手术创伤手术，以及培训创伤手术的培训途径的责任。
