Seadler Benjamin D, Smith Nathan J, Ramamurthi Adhitya, Zelten James, Alagoa Karina, Joyce Lyle D, Joyce David L
Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States of America.
Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, TN, United States of America.
Surg Open Sci. 2024 Jul 3;20:136-139. doi: 10.1016/j.sopen.2024.06.008. eCollection 2024 Aug.
The optimal training program to transform a new resident into a competent and capable surgeon is constantly evolving. Competency-based evaluation represents a change in mindset from quantitative or chronologic metrics for graduate readiness. As surgery becomes more specialized, more dependent on technology, and more public, we must continue to improve our ability to pass on technical skills. Approaching surgery in a component-based fashion enables even the most complex operation to be broken down into smaller sets of steps that range the entire spectrum of complexity. Treating an operation through the lens of its components, emphasizing stepwise forward progression in a trainee's experience, may provide a way to train competent surgeons more efficiently. Current case-logging products do not provide adequate granularity to apply this methodology.
Application design relied on the involvement of local surgeons from all specialties and subspecialties related to general surgical training. Individual interviews with multiple experts in each field were used to generate a list of most commonly performed operations. Once a consensus was reached, the same surgeons were queried on what they felt were the core steps that make up each operation. This information was utilized to create a novel mobile application which enables the user to record cases by date, attending surgeon, specific operation, and which portions of the operation they were able/allowed to perform.
Component-based case logging through the Logix application may be a useful adjunct as we continue to implement competency-based surgical training. Future investigation will assess user experience and compare subjective and objective metrics of training progression between the Logix application and currently utilized products. The information provided by the application stands to benefit not just trainees, but educators, training programs, and regulatory bodies.
Component-based case logging via a novel mobile application stands to increase the efficiency of surgical training and more effectively assess trainee competency.
将一名新住院医生转变为一名称职且有能力的外科医生的最佳培训方案在不断发展。基于能力的评估代表了一种思维方式的转变，从用于评估毕业生准备情况的定量或按时间顺序的指标转变而来。随着外科手术变得更加专业化、更加依赖技术且更受公众关注，我们必须持续提高传授技术技能的能力。以基于组件的方式处理手术，即使是最复杂的手术也能被分解为一系列更小的步骤，这些步骤涵盖了整个复杂程度范围。从手术组件的角度看待手术，强调学员经验中的逐步推进，可能提供一种更有效地培训合格外科医生的方法。当前的病例记录产品没有提供足够的粒度来应用这种方法。
应用程序设计依赖于来自与普通外科培训相关的所有专科和亚专科的当地外科医生的参与。通过对每个领域的多位专家进行个人访谈，生成最常进行的手术列表。一旦达成共识，就向同一位外科医生询问他们认为构成每个手术的核心步骤是什么。这些信息被用于创建一个新颖的移动应用程序，该应用程序允许用户按日期、主刀医生、具体手术以及他们能够/被允许执行的手术部分来记录病例。
通过Logix应用程序进行基于组件的病例记录可能是我们继续实施基于能力的外科培训时的一个有用辅助工具。未来的研究将评估用户体验，并比较Logix应用程序与当前使用的产品在培训进展方面的主观和客观指标。该应用程序提供的信息不仅对学员有益，对教育工作者、培训项目和监管机构也有益。
通过一个新颖的移动应用程序进行基于组件的病例记录，有望提高外科培训的效率，并更有效地评估学员的能力。
