Division of General Surgery, Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL, UK.
Department of Surgery and Cancer, Imperial College London, London, UK.
BMC Med Educ. 2023 Jan 23;23(1):51. doi: 10.1186/s12909-022-03941-3.
General surgery departments are busy, meaning educational opportunities may be sporadic. Clinical priorities can sometimes supersede teaching and trainees may feel alienated at the periphery of the working community. In this study, we demonstrate how a reflective, multidisciplinary general surgery teaching programme was established and use this to assess the impact of structured teaching on surgical doctors of all grades in the department.
Twelve semi-structured telephone interviews were conducted with participants of varying grades. Transcripts were analysed using a grounded theory thematic analysis, revealing four themes: the value of teaching; learning as a community; barriers to successful training; and culture of surgery.
Teaching helped juniors construct healthy narratives around general surgery and encouraged a process of professional identity formation. Pairing junior and senior colleagues allowed both to develop their skills, and reflective learning revealed new learning opportunities. Transparency across the 'community of practice' was achieved and the programme helped juniors overcome negative stereotypes of intimidation embedded in the hidden surgical curriculum.
Reflective, multidisciplinary learning can challenge the hidden curriculum and encourage team cohesion. A commitment to critical reflective teaching will be vital in cultivating surgeons of the future.
普通外科部门非常繁忙，这意味着教育机会可能较为零散。临床工作的优先级有时会高于教学，而受训者可能会感到自己在工作群体的边缘被边缘化。在这项研究中，我们展示了如何建立一个反思性的、多学科的普通外科教学计划，并利用该计划评估结构化教学对该部门各级外科医生的影响。
对不同级别参与者进行了 12 次半结构化电话访谈。使用扎根理论主题分析对转录本进行分析，揭示了四个主题：教学的价值；作为一个社区的学习；成功培训的障碍；以及外科文化。
教学帮助初级医生围绕普通外科构建健康的叙述，并鼓励专业身份形成的过程。将初级和高级同事配对可以让双方都发展自己的技能，而反思性学习则揭示了新的学习机会。“实践共同体”中的透明度得以实现，该计划帮助初级医生克服了隐藏在隐性外科课程中的恐吓的负面刻板印象。
反思性的、多学科的学习可以挑战隐性课程并鼓励团队凝聚力。承诺进行批判性反思性教学对于培养未来的外科医生至关重要。
