Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA; Department of Surgery, Boston Medical Center, Boston University, Boston, MA.
Department of Surgery, Veterans Affairs Boston Healthcare System, Boston, MA; Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
J Surg Educ. 2024 Nov;81(11):1491-1497. doi: 10.1016/j.jsurg.2024.07.005. Epub 2024 Aug 31.
Concerns exist about clinical and operative skill decay in surgery residents when they dedicate time away from clinical training to pursue research. However, it remains undetermined how to best prevent these negative impacts. Our study evaluated the perspectives of surgical research residents on interventions to improve their reentry into clinical training.
DESIGN, SETTING, AND PARTICIPANTS: An anonymous web-based survey was distributed between 5/01/2023 and 6/01/2023 to 102 current and former (within the previous 3 years) general surgery research residents from 4 academic medical centers in Boston, MA.
Survey response rate was 35.3% (36/102 residents). About 22 of 36 residents (61.1%) felt that their clinical aptitude decreased during the research years, whereas 33 of 36 (91.7%) reported reduced surgical skills. When reflecting on their re-entry to residency, former research residents reported feeling anxious and less confident (3.84/5 on a 1-5 Likert scale) as well as being below the expected level of clinical performance (3.42/5). Most of them (12 of 17; 70.6%) reported that it took up to 6 months, whereas 5 of them (29.4%) up to 12 months to feel at the expected level. When compared to nonmoonlighting residents, those who moonlighted often and operated during moonlighting, denied a decrease in clinical and surgical skills, and reported less anxiety, higher confidence, and a quicker return to the expected level of performance. Interventions proposed for improving their clinical re-entry included individualized development plans for 3 months before returning to clinical training, established curriculum for clinical work throughout the research years, clinical preceptorships throughout the research years, and simulation curriculum throughout the research years.
General surgery residents feel that their clinical and surgical skills decreased during the research years, leading to anxiety and lack of confidence when returning to residency. Therefore, comprehensive interventions are needed to improve the reentry of the research residents into clinical training.
当外科住院医师将时间用于从事研究而离开临床培训时，人们对其临床和手术技能的衰退存在担忧。然而，目前尚不清楚如何最好地防止这些负面影响。我们的研究评估了外科研究住院医师对改善其重返临床培训的干预措施的看法。
设计、地点和参与者：2023 年 5 月 1 日至 6 月 1 日期间，我们向马萨诸塞州波士顿的 4 家学术医疗中心的 102 名现任和前任（在过去 3 年内）普通外科研究住院医师分发了一份匿名的网络调查。
调查回复率为 35.3%（36/102 名住院医师）。在 36 名住院医师中，约有 22 名（61.1%）认为他们在研究期间临床能力下降，而 33 名（91.7%）报告手术技能下降。在回顾他们重返住院医师培训时，前研究住院医师报告感到焦虑和缺乏信心（1-5 分制中得 3.84 分），并且临床表现低于预期水平（3.42/5）。他们中的大多数（17 人中的 12 人；70.6%）报告说需要长达 6 个月的时间，而其中 5 人（29.4%）需要长达 12 个月的时间才能达到预期水平。与非兼职住院医师相比，经常兼职且在兼职期间进行手术的住院医师否认其临床和手术技能下降，并且报告焦虑程度较低、信心较高、重返预期水平的速度较快。为改善其临床重返而提出的干预措施包括在返回临床培训前 3 个月制定个性化发展计划、在研究期间为临床工作制定课程、在研究期间提供临床指导以及在研究期间提供模拟课程。
普通外科住院医师认为他们在研究期间的临床和手术技能下降，导致重返住院医师培训时感到焦虑和缺乏信心。因此，需要综合干预措施来改善研究住院医师重返临床培训。
