Nofi Colleen P, Roberts Bailey K, Hansen Laura, Coppa Gene F, Patel Vihas
Northwell North Shore University Hospital/Long Island Jewish Medical Center Department of Surgery, Manhasset, New York.
Northwell North Shore University Hospital/Long Island Jewish Medical Center Department of Surgery, Manhasset, New York.
J Surg Educ. 2023 Oct;80(10):1385-1394. doi: 10.1016/j.jsurg.2023.07.016. Epub 2023 Aug 9.
Select general surgery residents in the surgeon-scientist pipeline dedicate time away from clinical residency to conduct research. However, these research residents (RR) are vulnerable to operative skill decay. The aim of this study is to assess the feasibility of implementation and impact of an organized intervention designed to combat skill decay experienced by RR.
RR were enrolled in a pilot Surgical Rehabilitation Program (SRP). The SRP is comprised of 12 cadaver-based simulation sessions and supplemented with Fundamentals of Laparoscopic Surgery-based simulation workouts. The RR were integrated with the clinical residents (CR) during the cadaver sessions and were subsequently performance tested, surveyed, and interviewed.
One academic general surgery residency program graduating 8 chief residents yearly in New York.
General surgery CR and residents on dedicated research years.
Data were collected for all local RR (n = 8) and 77% (n = 37) of CR. Local RR conducted research within the same health system that sponsors the residency. RR experienced gaps in training ranging from 2 to 4 years. All RR were permitted to moonlight on surgical services, however performed 0 operations and only 0.88 procedures on average per shift. Although RR performed similarly to level-matched CR on basic laparoscopic tasks, they required significantly more time on laparoscopic suturing-based skills than CR (p < 0.001). RR had significantly lower confidence levels precadaver sessions but gained confidence postcadaver sessions (p < 0.05), whereas CR confidence was unchanged. Regarding the SRP, qualitative interviews revealed major themes emphasizing the integration of RR, exposure to CR and faculty, technical skill development, maintenance of surgical know-how, and improved confidence for RR.
The implementation of such structured interventions, like our SRP, aimed at supporting RR over gap years is essential to help residents maintain skills and confidence needed to achieve their goals of becoming surgeon scientists.
处于外科医生 - 科学家培养路径中的普通外科住院医师会抽出时间暂离临床住院医师工作去开展研究。然而，这些从事研究的住院医师（RR）容易出现手术技能衰退。本研究的目的是评估一项有组织的干预措施的实施可行性及其对RR所经历的技能衰退的影响。
RR参加了一个试点外科康复项目（SRP）。该SRP由12次基于尸体的模拟课程组成，并辅以基于腹腔镜手术基础的模拟训练。RR在尸体模拟课程期间与临床住院医师（CR）一起参与，并随后接受性能测试、调查和访谈。
纽约一个每年有8名总住院医师毕业的学术性普通外科住院医师项目。
普通外科CR以及处于专门研究年份的住院医师。
收集了所有本地RR（n = 8）和77%（n = 37）的CR的数据。本地RR在赞助住院医师项目的同一卫生系统内开展研究。RR经历了2至4年的培训空白期。所有RR都被允许在外兼职从事外科服务工作，但平均每班实施0例手术，仅实施0.88例操作。虽然RR在基本腹腔镜任务上的表现与水平匹配的CR相似，但他们在基于腹腔镜缝合的技能上所需时间比CR显著更多（p < 0.001）。RR在尸体模拟课程前的信心水平显著较低，但在尸体模拟课程后信心增强（p < 0.05），而CR的信心没有变化。关于SRP，定性访谈揭示了一些主要主题，强调RR的融入、与CR及教员的接触、技术技能发展、外科知识的保持以及RR信心的提升。
实施像我们的SRP这样旨在在间隔年支持RR的结构化干预措施，对于帮助住院医师维持实现其成为外科医生科学家目标所需的技能和信心至关重要。
