Do Attending and Trainee Surgeons Agree on What Happens in the Operating Room During Septoplasty?
Do Attending and Trainee Surgeons Agree on What Happens in the Operating Room During Septoplasty?
复制标题
主治外科医生和见习外科医生对鼻中隔成形术期间手术室中发生的情况是否达成一致？
DOI：
10.1089/fpsam.2021.0327
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发表时间：
2022
影响因子：
2
通讯作者：
Ishii,Masar
中科院分区：
文献类型：
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作者：
Ryan,JohnF;Malpani,Anand;Naz,Hajira;Boahene,KofiDO;Papel,IraD;Kontis,ThedaC;Maxwell,JessicaH;Creighton,FrancisX;Byrne,PatrickJ;Wanamaker,JohnR;Hager,GregoryD;Vedula,SSwaroop;Malekzadeh,Sonya;Ishii,LisaE;Ishii,Masar
背景：外科医生必须选择复杂程度与其技能相匹配的病例。目标：确定学员报告参与手术的准确程度、判断病例复杂性并评估他们自己的技能。方法：我们从两个耳鼻喉科招募了主治医师和学员。进行鼻中隔成形术后，他们使用鼻中隔成形术整体评估工具 (SGAT) 和视觉模拟量表 (VAS) 完成了关于病例复杂性、目标实现情况、谁执行了哪些步骤以及学员技能的相同调查。使用科恩卡帕系数 (κ) 评估受训者执行哪些步骤的一致性。使用 Spearman 相关系数 (rho) 测量受训者和主治人员反应之间的相关性。结果：7 名主治人员和 42 名受训人员完成了 181 项配对调查。受训者和主治人员有时对于受训者执行哪些步骤存在分歧（范围κ= 0.743–0.846）。对于 VAS 技能评分（rho = 0.12–0.34 的范围）、SGAT 问题（rho = 0.03–0.53 的范围）和病例复杂性评估（rho = 0.24–0.48 的范围），主治医师和受训者的反应之间的相关性较低。结论：受训者有时不同意主治人员关于他们执行和正在执行哪些鼻中隔成形术步骤。他们判断复杂性、目标和技能的能力有限。
Background:Surgeons must select cases whose complexity aligns with their skill set.Objectives:To determine how accurately trainees report involvement in procedures, judge case complexity, and assess their own skills.Methods:We recruited attendings and trainees from two otolaryngology departments. After performing septoplasty, they completed identical surveys regarding case complexity, achievement of goals, who performed which steps, and trainee skill using the septoplasty global assessment tool (SGAT) and visual analog scale (VAS). Agreement regarding which steps were performed by the trainee was assessed with Cohen's kappa coefficients (κ). Correlations between trainee and attending responses were measured with Spearman's correlation coefficients (rho).Results:Seven attendings and 42 trainees completed 181 paired surveys. Trainees and attendings sometimes disagreed about which steps were performed by trainees (range ofκ= 0.743–0.846). Correlation between attending and trainee responses was low for VAS skill ratings (range of rho = 0.12–0.34), SGAT questions (range of rho = 0.03–0.53), and evaluation of case complexity (range of rho = 0.24–0.48).Conclusion:Trainees sometimes disagree with attendings about which septoplasty steps they perform and are limited in their ability to judge complexity, goals, and their skill.