Medical College of Wisconsin, Milwaukee, Wisconsin.
University of California, San Francisco (UCSF), San Francisco, California.
J Bone Joint Surg Am. 2023 Sep 6;105(17):1344-1353. doi: 10.2106/JBJS.23.00321. Epub 2023 Jul 27.
Given the growing interest among international surgeons to participate in North American clinical observerships, it is essential to incorporate international surgeons' views to further enhance the program's applicability, value, and accessibility. In this qualitative follow-up study, we explored the motivations, relevance, and opinions about alternate learning platforms among the international surgeons who had participated in a pediatric orthopaedic clinical observership in North America.
Using a semistructured interview guide, international surgeons who had participated in a North American pediatric orthopaedic observership during 2009 to 2019 were interviewed until data saturation and inductive thematic saturation were reached. Twenty-one international surgeons representing 15 different countries (1 from a low-income country, 10 from a lower middle-income country, 8 from an upper middle-income country, and 2 from a high-income country) were interviewed.
The most commonly cited motivations for doing a clinical observership were to advance clinical training and learn specific skills. The clinical and nonclinical skills gained during the observership, such as utilizing an integrated team approach and open communication style, were helpful to most interviewees; however, several respondents highlighted the critical need to adapt and modify surgical indications, techniques, and skills to suit their local environment and limited resource availability. Although respondents were interested in exploring virtual learning models to save time and expense, several preferred a hybrid model, including access to remote learning opportunities and sharing their own clinical experiences with the North American hosts.
Identifying the visiting surgeon's motivation for participation can allow North American hosts to align their clinical exposure more closely with the unique needs and aspirations of the international surgeons and enable a more relevant exchange of clinical and nonclinical skills. Use of a blended learning model, including in-person and virtual learning platforms, and the missed opportunity of having the international surgeons share their clinical experiences and skills with their North American counterparts should be explored further.
鉴于国际外科医生对参与北美临床观摩的兴趣日益浓厚，将国际外科医生的观点纳入其中对于进一步提高该项目的适用性、价值和可及性至关重要。在这项定性随访研究中，我们探讨了参与过北美小儿矫形临床观摩的国际外科医生的动机、相关性以及对替代学习平台的看法。
我们采用半结构化访谈指南，对 2009 年至 2019 年期间参加过北美小儿矫形外科临床观摩的国际外科医生进行了访谈，直至达到数据饱和和归纳主题饱和。我们采访了来自 15 个不同国家的 21 名国际外科医生（1 名来自低收入国家，10 名来自中下收入国家，8 名来自中上收入国家，2 名来自高收入国家）。
参加临床观摩最常被提及的动机是为了提高临床培训和学习特定技能。观摩期间获得的临床和非临床技能，如利用综合团队方法和开放沟通方式，对大多数受访者都有帮助；然而，一些受访者强调需要适应和修改手术指征、技术和技能，以适应他们当地的环境和有限的资源可用性。尽管受访者对探索虚拟学习模式以节省时间和费用感兴趣，但一些人更喜欢混合模式，包括获得远程学习机会和与北美主持人分享自己的临床经验。
确定来访外科医生参与的动机可以使北美主持人更紧密地将其临床暴露与国际外科医生的独特需求和愿望保持一致，并使临床和非临床技能的交流更加相关。应进一步探讨使用混合学习模式，包括面授和虚拟学习平台，以及国际外科医生与北美的同行分享他们的临床经验和技能的机会。
