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远程指导作为外科医生在职持续专业发展干预措施的教育效果:一项系统综述

Educational Effectiveness of Telementoring as a Continuing Professional Development Intervention for Surgeons in Practice: A Systematic Review.

作者信息

Fernandes Rosephine Del, Ghasroddashti Arashk, Sorefan-Mangou Fatimah, Williams Erin, Choi Ken, Fasola Laurie, Szasz Peter, Zevin Boris

机构信息

From the The School of Medicine, Queen's University, Kingston, Ontario, Canada.

Department of Surgery, Queen's University, Kingston, Ontario, Canada.

出版信息

Ann Surg Open. 2023 Sep 28;4(4):e341. doi: 10.1097/AS9.0000000000000341. eCollection 2023 Dec.

Abstract

OBJECTIVE

We performed a systematic review to determine the educational effectiveness of telementoring as a continuing professional development (CPD) intervention for surgeons in practice.

BACKGROUND

Surgeons can mentor their peers in remote locations using videoconferencing communication, referred to as telementoring.

METHODS

We searched MEDLINE and EMBASE and included studies assessing the educational effectiveness of telementoring interventions used by surgeons in practice. We excluded studies involving only trainees and those not evaluating educational effectiveness. Two reviewers independently screened, extracted data, and assessed study quality using the Medical Education Research Study Quality Instrument (MERSQI; maximum score 18). Educational outcomes were categorized using Moore's Outcomes Framework.

RESULTS

We retrieved a total of 1351 records, and 252 studies were selected for full-text review. Twenty-eight studies were included with 1 randomized controlled trial, 19 cohort studies, 5 qualitative studies, and 3 case studies, totaling 178 surgeons and 499 cases. The average MERSQI score was 10.21 ± 2.2 out of 18. Educational outcomes included surgeons' satisfaction with telementoring interventions (Moore's Level 2) in 12 studies, improvement in surgeons' procedural knowledge (Level 3b) in 3 studies, improvements in surgeons' procedural competence in an educational setting (Level 4) in 4 studies, performance in a workplace-based setting (Level 5) in 23 studies, and patient outcomes (Level 6) in 3 studies. No studies reported community health outcomes (Level 7).

CONCLUSIONS

Moderate-level evidence demonstrates the use of telementoring as effective in changing surgeons' knowledge and competence in both educational and workplace-based settings. Its use is also associated with changes in patient outcomes.

摘要

目的

我们进行了一项系统综述,以确定远程指导作为外科医生在职继续职业发展(CPD)干预措施的教育效果。

背景

外科医生可以使用视频会议通信对偏远地区的同行进行指导,这被称为远程指导。

方法

我们检索了MEDLINE和EMBASE,并纳入了评估外科医生在职使用远程指导干预措施的教育效果的研究。我们排除了仅涉及实习生的研究以及未评估教育效果的研究。两名评审员独立进行筛选、提取数据,并使用医学教育研究质量工具(MERSQI;最高分为18分)评估研究质量。教育成果使用摩尔成果框架进行分类。

结果

我们共检索到1351条记录,252项研究被选进行全文审查。纳入了28项研究,其中包括1项随机对照试验、19项队列研究、5项定性研究和3项案例研究,共有178名外科医生和499个病例。MERSQI平均得分为18分中的10.21±2.2分。教育成果包括12项研究中外科医生对远程指导干预措施的满意度(摩尔二级)、3项研究中外科医生程序知识的提高(三级b)、4项研究中外科医生在教育环境中程序能力的提高(四级)、23项研究中在工作场所环境中的表现(五级)以及3项研究中患者的结局(六级)。没有研究报告社区健康结局(七级)。

结论

中等水平的证据表明,远程指导在改变外科医生在教育和工作场所环境中的知识和能力方面是有效的。其使用也与患者结局的变化有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dc0/10735140/c5c6d8a677e3/as9-4-e341-g001.jpg

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