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外科医生知道他们并不了解手术能量的安全使用:一项国际研究表明,知识差距仍然存在。

Surgeons know that they don't know about the safe use of surgical energy: an international study reveals that the knowledge gap persists.

机构信息

Pirogov Russian National Research Medical University, Ostrovityanova st., 1, Moscow, 127434, Russia.

出版信息

Surg Endosc. 2023 Jun;37(6):4673-4680. doi: 10.1007/s00464-023-09936-5. Epub 2023 Mar 6.

Abstract

INTRODUCTION

The rate of electrosurgery complications is 0.1-2.1%. More than 10 years ago, SAGES pioneered a well-structured educational program (FUSE) aimed to teach about the safe use of electrosurgery. This inspired the development of similar training programs around the globe. Still, the knowledge gap persists among surgeons, possibly due to the lack of judgment.

AIM

To investigate factors affecting the level of expertise in electrosurgical safety and their correlation with self-assessment scores among surgeons and surgical residents.

MATERIALS AND METHODS

We conducted an online survey consisting of 15 questions that could be thematically broken down into 5 blocks. We analyzed how the objective scores were correlated with the self-assessment scores, professional experience, past participation in training programs, and work at a teaching hospital.

RESULTS

A total of 145 specialists took part in the survey, including 111 general surgeons and 34 s-year surgical residents from Russia, Belarus, Ukraine, and Kirgizia. Only 9 (8.1%) surgeons scored "excellent," 32 (28.8%) scored "good," and 56 (50.4%) scored "fair." Of all surgical residents participating in the study, only 1 (2.9%) scored "excellent," 9 (26.5%) scored "good," and 11 (32.4%) scored "fair." The test was failed by 14 surgeons (12.6%) and 13 (38.2%) residents. The difference between the trainees and the surgeons was statistically significant. Our multivariate logistic model identified 3 significant factors predisposing to successful performance on the test: past training in the safe use of electrosurgery, professional experience, and work at a teaching hospital. Of all study participants, those with no past training in the safe use of electrosurgery, and non-teaching surgeons were the most realistic about their competencies.

CONCLUSION

We have identified alarming gaps in the knowledge of electrosurgical safety among surgeons. Faculty staff and experienced surgeons scored higher, but past training was the most influential factor in improving knowledge of electrosurgical safety.

摘要

简介

电外科并发症的发生率为 0.1-2.1%。10 多年前,SAGES 率先开展了一项结构合理的教育计划(FUSE),旨在教授电外科的安全使用。这激发了全球类似培训计划的发展。尽管如此,外科医生之间仍然存在知识差距,这可能是由于缺乏判断力。

目的

调查影响电外科安全专业知识水平的因素,并分析其与外科医生和外科住院医师自我评估评分的相关性。

材料和方法

我们进行了一项在线调查,共包含 15 个问题,可以分为 5 个板块。我们分析了客观分数如何与自我评估分数、专业经验、过去参加培训计划的情况以及在教学医院工作相关。

结果

共有 145 名专家参与了调查,其中包括来自俄罗斯、白俄罗斯、乌克兰和吉尔吉斯斯坦的 111 名普通外科医生和 34 名外科住院医师。只有 9 名(8.1%)外科医生得分为“优秀”,32 名(28.8%)得分为“良好”,56 名(50.4%)得分为“一般”。在所有参与研究的外科住院医师中,只有 1 名(2.9%)得分为“优秀”,9 名(26.5%)得分为“良好”,11 名(32.4%)得分为“一般”。有 14 名外科医生(12.6%)和 13 名(38.2%)住院医师未能通过测试。受训者和外科医生之间的差异具有统计学意义。我们的多变量逻辑模型确定了 3 个导致测试表现成功的重要因素:过去接受过安全使用电外科的培训、专业经验和在教学医院工作。在所有研究参与者中,那些过去没有接受过安全使用电外科培训且不在教学医院工作的人对自己的能力最为现实。

结论

我们发现外科医生在电外科安全知识方面存在令人震惊的差距。教员和有经验的外科医生得分较高,但过去的培训是提高电外科安全知识的最具影响力的因素。

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