Department of Surgery, University of California, San Francisco, CA.
Department of Surgery, University of California, San Francisco, CA.
J Surg Educ. 2024 Oct;81(10):1437-1445. doi: 10.1016/j.jsurg.2024.06.020. Epub 2024 Aug 10.
The healthcare sector accounts for 8.5% of United States (U.S.) greenhouse gas emissions, of which one-third comes from operating rooms (ORs). As a result, there is great interest in decarbonizing the OR and surgical care. However, surgical residents are not routinely educated on the negative environmental impact of surgery or how to reduce it. In this paper, we present a formal needs assessment for a sustainability curriculum geared towards surgical residents.
Using Kern's Six-Step Framework for curriculum development, we conducted focus groups with surgical residents to perform a targeted needs assessment on 3 main topics: 1) the current state of surgical sustainability curricula; 2) resident knowledge regarding the environmental impact of surgery and barriers to sustainable practice; and 3) preferred educational methods and topics within sustainability education. We audio-recorded all focus groups and performed thematic analysis using anonymized transcripts.
Fourteen residents participated in 3 focus groups, from which a qualitative analysis revealed 4 themes. First, surgery residents receive limited formal teaching on the negative environmental impact of surgical care or how to reduce this impact. Second, surgery residents have variable levels of prior education about and interest in sustainability in surgery. Third, several barriers prevent the implementation of sustainable changes in surgical practice, including a lack of institutional initiative, cultural inertia, concerns about workflow efficiency, and limited formal education. Finally, residents prefer to learn about practical ways to reduce waste, specifically through interactive approaches such as quality improvement initiatives.
Given the increasing importance of sustainability in surgery, there is an urgent need for formal resident education on this topic. This needs assessment provides a valuable foundation for future sustainability curriculum development.
医疗保健行业占美国温室气体排放量的 8.5%，其中三分之一来自手术室。因此，人们对实现手术室和外科护理的脱碳非常感兴趣。然而，外科住院医师通常没有接受过关于手术的环境负面影响或如何减少这种影响的教育。在本文中，我们提出了一个针对外科住院医师的可持续性课程的正式需求评估。
使用 Kern 的六步课程开发框架，我们对外科住院医师进行了焦点小组讨论，以针对以下 3 个主要主题进行有针对性的需求评估：1）外科可持续性课程的现状；2）住院医师对手术的环境影响以及可持续实践障碍的了解；3）可持续教育内的首选教育方法和主题。我们对所有焦点小组进行了录音，并使用匿名转录本进行了主题分析。
14 名住院医师参加了 3 个焦点小组，从定性分析中揭示了 4 个主题。首先，外科住院医师接受的关于手术护理的负面环境影响或如何减少这种影响的正式教学有限。其次，外科住院医师对手术中的可持续性有不同程度的先前教育和兴趣。第三，有几个障碍阻止了可持续的手术实践变革的实施，包括缺乏机构主动性、文化惯性、对工作流程效率的担忧以及有限的正规教育。最后，住院医师希望通过质量改进举措等互动方法学习减少浪费的实用方法。
鉴于可持续性在外科中的重要性日益增加，因此迫切需要对这一主题进行住院医师的正规教育。这项需求评估为未来的可持续性课程开发提供了有价值的基础。
