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现在由你负责:探索麻醉实习医生与其指导专家之间的教育关系。

You are in charge now: exploration of educational relationships between anaesthetic trainees and their supervising specialists.

作者信息

Hodgson Timothy, Brazil Victoria, Purdy Eve

机构信息

Department of Anaesthetics, Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.

Faculty of Health Sciences and Medicine Bond University, Gold Coast, Queensland, Australia.

出版信息

BJA Open. 2023 Apr 15;6:100137. doi: 10.1016/j.bjao.2023.100137. eCollection 2023 Jun.

Abstract

BACKGROUND

Much of the education during anaesthesia training occurs in the workplace where trainees work under the close supervision of a more senior anaesthetist. Trainee anaesthetists are exposed to multiple supervisors with whom they form educational and supervisory relationships over the course of their training. Surprisingly little research has been conducted to explore the factors behind the development and maintenance of these relationships. This study explores the process of how education occurs in the workplace by examining the relationship from the perspective of both trainees and specialists.

METHODS

This is an exploratory qualitative study. Eight trainee and 10 specialist anaesthetists participated in an individual semi-structured interview. The data were analysed thematically by each of the authors to generate themes.

RESULTS

Six themes were identified in the analysis: (1) sizing up; (2) negotiated autonomy; (3) working closely together; (4) workplace practices; (5) education being valued; and (6) gender. A conceptual model to illustrate the relationships between the six themes was developed.

CONCLUSIONS

Supervisory relationships were viewed positively by participants despite impediments such as lack of continuity and busy clinical environments. But there were tensions, particularly in balancing trainee autonomy with patient safety. A nuanced 'sizing up' process, with negotiation of autonomy, was described by both supervisors and trainees Our findings may support supervisory relationships to reach this ideal more effectively.

摘要

背景

麻醉培训期间的大部分教育是在工作场所进行的,学员在资深麻醉师的密切监督下工作。实习麻醉医生会接触到多位上级,在培训过程中与他们建立起教育和监督关系。令人惊讶的是,很少有研究探讨这些关系发展和维持背后的因素。本研究从学员和专家的角度审视这种关系,探讨工作场所教育的发生过程。

方法

这是一项探索性定性研究。八名实习麻醉医生和十名专家麻醉医生参与了个人半结构化访谈。作者们分别对数据进行了主题分析以生成主题。

结果

分析确定了六个主题:(1)评估;(2)协商自主权;(3)紧密合作;(4)工作场所实践;(5)重视教育;(6)性别。构建了一个概念模型来说明这六个主题之间的关系。

结论

尽管存在缺乏连续性和临床环境繁忙等障碍,但参与者对监督关系持积极看法。但存在紧张关系,尤其是在平衡学员自主权与患者安全方面。上级和学员都描述了一个细致入微的“评估”过程以及自主权的协商。我们的研究结果可能有助于监督关系更有效地达到这一理想状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9751/10430800/2aa5712ce245/gr1.jpg

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