Bhatti Ahsin Manzoor, Ahsin Sadia, Mansoor Sumreena
Ahsin Manzoor Bhatti, Department of Vascular Surgery, CMH Rawalpindi, Pakistan.
Sadia Ahsin, Department of Physiology, Foundation University, Islamabad, Pakistan.
Pak J Med Sci. 2023 Jan-Feb;39(1):12-16. doi: 10.12669/pjms.39.1.6737.
To explore the feasibility of assessment of operative skills of FCPS vascular surgery trainees based on video recordings of the surgical procedures with a view to introduce it in the curriculum.
This qualitative study was carried out from 9 April 2021 - 15 July 2021 at Shifa Tameer e Millat University, Islamabad, Pakistan. It is a qualitative study based on constructivist grounded theory. Semi structured interviews of 16 participants, including five vascular surgical trainees, six vascular surgical consultants/supervisors/examiners, and five medical educationists were conducted, recorded and transcribed. Open and axial coding method was employed to identify recurring themes.
Six themes could be identified. (1) There was consensus among participants on deficiency in current assessment of surgical skills. (2) Most participants believed that this is a useful method, although four out of 16 participants believed that current methods were sufficient. (3) There was a unanimous opinion that its purpose should be initially formative assessment and later for summative assessment. (4) It was suggested that it is practical with logistic support; it can be made part of trainee's record to be reviewed later; maybe by independent observers. (5) Participants believed that the logistic issue in term of equipment and trained manpower will be a challenge in implementing this mode of assessment. Other barriers included medicolegal and ethical issue and acceptability by the stake holders. (6) Participants also suggested remedies for the barriers.
Video review of surgical procedures can improve assessment of operative skills of trainees provided it is used as formative tool initially with a need to overcome logistics, medicolegal and cultural barriers.
探讨基于手术过程视频记录评估FCPS血管外科实习生手术技能的可行性，以期将其纳入课程体系。
这项定性研究于2021年4月9日至2021年7月15日在巴基斯坦伊斯兰堡的希法塔米尔·伊·米拉特大学开展。这是一项基于建构主义扎根理论的定性研究。对16名参与者进行了半结构化访谈，包括5名血管外科实习生、6名血管外科顾问/导师/考官以及5名医学教育工作者，并进行了录音和转录。采用开放编码和轴心编码方法来识别反复出现的主题。
可识别出六个主题。（1）参与者们一致认为当前手术技能评估存在不足。（2）大多数参与者认为这是一种有用的方法，尽管16名参与者中有4人认为现有方法已足够。（3）一致认为其目的应首先用于形成性评估，之后用于总结性评估。（4）有人建议在后勤支持下这是可行的；可以将其作为实习生记录的一部分供日后审查；或许由独立观察员进行审查。（5）参与者们认为在设备和训练有素的人力方面的后勤问题将是实施这种评估模式的一个挑战。其他障碍包括法医学和伦理问题以及利益相关者的接受度。（6）参与者们还提出了克服这些障碍的补救措施。
手术过程的视频回顾可以改善对实习生手术技能的评估，前提是最初将其用作形成性工具，同时需要克服后勤、法医学和文化障碍。
