Centre for Healthcare Education Research and Innovation (CHERI), School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, AB25 2ZD, UK.
NHS Education for Scotland, Centre for Health Science, Inverness, UK.
Adv Health Sci Educ Theory Pract. 2023 May;28(2):499-518. doi: 10.1007/s10459-022-10170-2. Epub 2022 Oct 26.
Craft specialties such as surgery endured widespread disruption to postgraduate education and training during the pandemic. Despite the expansive literature on rapid adaptations and innovations, generalisability of these descriptions is limited by scarce use of theory-driven methods. In this research, we explored UK surgical trainees' (n = 46) and consultant surgeons' (trainers, n = 25) perceptions of how learning in clinical environments changed during a time of extreme uncertainty (2020/2021). Our ultimate goal was to identify new ideas that could shape post-pandemic surgical training. We conducted semi-structured virtual interviews with participants from a range of working/training environments across thirteen Health Boards in Scotland. Initial analysis of interview transcripts was inductive. Dynamic capabilities theory (how effectively an organisation uses its resources to respond to environmental changes) and its micro-foundations (sensing, seizing, reconfiguring) were used for subsequent theory-driven analysis. Findings demonstrate that surgical training responded dynamically and adapted to external and internal environmental uncertainty. Sensing threats and opportunities in the clinical environment prompted trainers' institutions to seize new ways of working. Learners gained from reconfigured training opportunities (e.g., splitting operative cases between trainees), pan-surgical working (e.g., broader surgical exposure), redeployment (e.g., to medical specialties), collaborative working (working with new colleagues and in new ways) and supervision (shifting to online supervision). Our data foreground the human resource and structural reconfigurations, and technological innovations that effectively maintained surgical training during the pandemic, albeit in different ways. These adaptations and innovations could provide the foundations for enhancing surgical education and training in the post-pandemic era.
手工艺专业，如外科学，在疫情期间的研究生教育和培训受到了广泛的干扰。尽管有大量关于快速适应和创新的文献，但由于缺乏理论驱动方法的应用，这些描述的普遍性受到限制。在这项研究中，我们探讨了英国外科受训者（n=46）和顾问外科医生（培训师，n=25）对学习环境在极度不确定时期（2020/2021 年）如何变化的看法。我们的最终目标是确定新的想法，以塑造大流行后的外科培训。我们对来自苏格兰十三个卫生委员会不同工作/培训环境的参与者进行了半结构化的虚拟访谈。访谈记录的初步分析是归纳性的。动态能力理论（组织如何有效地利用其资源来应对环境变化）及其微观基础（感知、捕捉、重新配置）用于随后的理论驱动分析。研究结果表明，外科培训具有动态响应能力，并适应了外部和内部环境的不确定性。在临床环境中感知威胁和机会促使培训师的机构抓住新的工作方式。学习者从重新配置的培训机会中获益（例如，将手术病例分配给受训者）、泛外科工作（例如，更广泛的外科暴露）、重新部署（例如，到医学专业）、协作工作（与新同事合作并以新的方式工作）和监督（转向在线监督）。我们的数据突出了在大流行期间有效维持外科培训的人力资源和结构重新配置，以及技术创新，尽管方式不同。这些适应和创新可以为后大流行时代的外科教育和培训提供基础。
