Policy options for surgical mentoring: Lessons from Zambia based on stakeholder consultation and systems science.
Policy options for surgical mentoring: Lessons from Zambia based on stakeholder consultation and systems science.
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DOI：
10.1371/journal.pone.0257597
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Bijlmakers L
中科院分区：
文献类型：
--
作者：
Broekhuizen H;Ifeanyichi M;Cheelo M;Drury G;Pittalis C;Rouwette E;Mbambiko M;Kachimba J;Brugha R;Gajewski J;Bijlmakers L
外科专家的监督是有益的，因为他们可以向地区医院一级的外科团队传授技能。在赞比亚的非洲区域可持续发展行动项目包括在选定的地区进行一项指导试验，涉及两个省级指导小组。本文的目的是探索政策选择嵌入这种手术指导在现有的政策结构，通过参与式建模方法。举办了四次小组模型建立讲习班，区医院和中央医院各两次。参与者在各种机构工作，并具有临床和/或行政背景。两名独立的评审员比较了因果循环图（CLD），导致这些研讨会在成对的方式来构建一个综合的CLD。用图论分析了集成化的CLD，用MARVEL方法研究了系统的动态行为。与主要利益攸关方合作建立省级指导系，将是协调和维持外科指导以及监测地区一级外科业绩的必要步骤。建议在省一级进行季度手术指导审查，以评估并在必要时调整指导。地区医院管理者需要密切监测学员的动机。手术指导可以在扩大地区一级手术方面发挥关键作用，但其实施是复杂的，需要指定省级协调和与相关利益攸关方定期接触。
Supervision by surgical specialists is beneficial because they can impart skills to district hospital-level surgical teams. The SURG-Africa project in Zambia comprises a mentoring trial in selected districts, involving two provincial-level mentoring teams. The aim of this paper is to explore policy options for embedding such surgical mentoring in existing policy structures through a participatory modeling approach. Four group model building workshops were held, two each in district and central hospitals. Participants worked in a variety of institutions and had clinical and/or administrative backgrounds. Two independent reviewers compared the causal loop diagrams (CLDs) that resulted from these workshops in a pairwise fashion to construct an integrated CLD. Graph theory was used to analyze the integrated CLD, and dynamic system behavior was explored using the Method to Analyse Relations between Variables using Enriched Loops (MARVEL) method. The establishment of a provincial mentoring faculty, in collaboration with key stakeholders, would be a necessary step to coordinate and sustain surgical mentoring and to monitor district-level surgical performance. Quarterly surgical mentoring reviews at the provincial level are recommended to evaluate and, if needed, adapt mentoring. District hospital administrators need to closely monitor mentee motivation. Surgical mentoring can play a key role in scaling up district-level surgery but its implementation is complex and requires designated provincial level coordination and regular contact with relevant stakeholders.
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影响因子：
1.7
作者：
Pittalis, Chiara;Brugha, Ruairi;Gajewski, Jakub
通讯作者：
Gajewski, Jakub
DOI：
10.1016/j.injury.2015.11.042
发表时间：
2016-05-01
影响因子：
2.5
作者：
Peter, N. A.;Pandit, H.;Lavy, C.
通讯作者：
Lavy, C.
影响因子：
2.7
作者：
Hovmand, Peter S.;Andersen, David F.;Calhoun, Annaliese
通讯作者：
Calhoun, Annaliese
影响因子：
4.5
作者：
Gajewski, Jakub;Monzer, Nasser;Brugha, Ruairi
通讯作者：
Brugha, Ruairi
DOI：
10.1186/1748-5908-8-117
发表时间：
2013-10-02
期刊：
Implementation science : IS
影响因子：
--
作者：
Chambers DA;Glasgow RE;Stange KC
通讯作者：
Stange KC