Holding the Scalpel: Achieving Surgical Care in a Learning Environment
Holding the Scalpel: Achieving Surgical Care in a Learning Environment
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DOI：
10.1177/0891241613485905
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发表时间：
2014-02-01
影响因子：
1.6
通讯作者：
Kneebone, Roger
中科院分区：
文献类型：
--
作者：
Bezemer, Jeff;Cope, Alexandra;Kneebone, Roger
在本文中，我们展示了现场手术训练的样子。我们借鉴伦敦一家医院的实地工作，探讨了当受训者手持手术刀时，培训师和受训者如何共同实现手术护理。我们通过对手术室中音频和视频录制的互动进行转录和分析，使这种常见的教学安排变得可见。通过对动作和言语的时间展开的即时分析，我们发现受训者用手术刀执行的动作充当迷你手势，向培训师发出受训者将在何时何地进行切割的信号。培训师阅读这些手势，并通过口头表达提示受训者继续或改变他的行动方针。我们使用我们的人种学描述作为详细的实证参考点，以反思手术室中外科教育和患者安全的挑战和可能性。
In this article, we show what surgical training looks like in situ. Drawing on fieldwork in a London hospital, we explore how a trainer and trainee jointly achieve surgical care when the trainee holds the scalpel. We make this common pedagogic arrangement visible through transcription and analysis of audio- and video-recorded interaction in the operating theater. Through moment-by-moment analysis of the temporal unfolding of action and speech, we show that the actions performed by the trainee with the scalpel serve as mini-gestures, signaling to the trainer where and when the trainee is going to cut. The trainer reads these gestures and prompts the trainee to continue or change his course of action through spoken utterances. We use our ethnographic account as a detailed empirical point of reference for reflecting on the challenges and possibilities of surgical education and patient safety in the operating theater.