An audit of clinical training exposure amongst junior doctors working in Trauma & Orthopaedic Surgery in 101 hospitals in the United Kingdom
An audit of clinical training exposure amongst junior doctors working in Trauma & Orthopaedic Surgery in 101 hospitals in the United Kingdom
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DOI：
10.1186/s12909-017-1038-5
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发表时间：
2018-01-02
影响因子：
3.6
通讯作者：
Rashid, Mustafa S.
中科院分区：
文献类型：
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作者：
Rashid, Mustafa S.
背景：在英国，人们对创伤和矫形外科（T&O）初级医生的早期培训感到担忧。我们的主要目标是审计初级医生在创伤和骨科（T&O）手术在国家卫生服务（NHS）在一个典型的工作周进行的临床活动。一个次要目标是审计的初级外科医生在培训中的临床暴露，以联合委员会对手术培训（JCST）的标准，每周最低临床暴露在T&O surgery.Methods：我们招募了合作者在101 T&O外科部门在NHS医院参加这项研究。参与的临床活动日记来自101家参与NHS医院的935名T&O手术医生。涵盖初级待命层的所有初级医生都包括在内。合作者收集了2015年1月18日08：00至2015年1月22日20：00的临床活动数据。根据医生在大部分会话中进行的活动，记录会话（上午、下午、晚上）中的临床活动。临床活动分为手术室/手术室、门诊、随叫随到、“不工作”（即休假、生病）、教学和病房覆盖会议。根据JCST的两个最低每周临床暴露标准分析核心外科受训者（CST）的每周临床活动。总体而言，在T&O手术中工作的初级医生参加了8.5%的手术室会议，3.2%的门诊，14.8%的随叫随到，1.7%的教学会议，34.6%的病房覆盖率，而在零会话中有20.7%的时间。只有5%的核心外科实习生（n = 200）同时满足JCST关于该专业每周最低临床暴露的标准。结论：在英国接受培训、在创伤和骨科手术工作的初级外科医生没有达到最低要求每周临床会议由JCST规定。进一步开展工作，开发能够增强培训经验和改善手术名单和门诊诊所的临床接触的模式，将是有益的。
Background: There are concerns regarding early years' training for junior doctors in Trauma & Orthopaedic Surgery (T&O) in the United Kingdom. Our primary objective was to audit the clinical activities undertaken by junior doctors working in Trauma & Orthopaedic (T&O) surgery in the National Health Service (NHS) in a typical workweek. A secondary objective was to audit the clinical exposure of junior surgeons in training to the Joint Committee on Surgical Training (JCST) standards for minimum weekly clinical exposure in T&O surgery.Methods: We recruited collaborators in 101 T&O surgery departments in NHS hospitals to participate in this study. Clinical activity diaries from 935 doctors working in T&O surgery in the 101 participating NHS hospitals were involved. All junior doctors covering the junior on call tier were included. Collaborators collected clinical activity data from 08:00 18/01/2015 to 20:00 22/01/2015. Clinical activities recorded in sessions (morning, afternoon, evening) depending on what activity that doctor undertook for the majority of that session. Clinical activities were grouped into operating theatre/room, outpatient clinic, on call, "not in work" (i.e. leave, sickness), teaching, and ward cover sessions. The weekly clinical activity of Core Surgical Trainees (CSTs) were analyzed in accordance to two JCST standards for minimum weekly clinical exposure.Results: Overall, junior doctors working in T&O surgery attended a theatre list session 8.5% of the time, an outpatient clinic 3.2%, were on call 14.8%, a teaching session 1.7%, providing ward cover 34.6%, and on a zero session 20.7% of the time. Only 5% of core surgical trainees (n = 200) met both the JCST standards for minimum weekly clinical exposure in the specialty.Conclusions: Junior surgeons in training, working in Trauma & Orthopaedic surgery in the United Kingdom are not meeting the minimum weekly clinical sessions laid out by the JCST. Further work to develop models allowing for enhanced training experiences and improved clinical exposure to operating lists and outpatient clinics would be beneficial.