Trainee as trainer in paediatric laparoscopic appendicectomy.

IF 1.1 4区 医学 Q3 SURGERY
L Henderson, N Patwardhan, H Dagash
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引用次数: 0

Abstract

Background: Intraoperative teaching is an essential surgical skill, but there is little literature regarding trainees acting as trainers; we characterised these cases in paediatric laparoscopic appendicectomy.

Methods: This is a retrospective review of casenotes over two years (2015-2017) in a single tertiary paediatric surgical centre in the UK. Operating were: paediatric surgery Core Trainees (CT) (postgraduate year (PGY)3-4), Junior Registrars (JR) (PGY5-6) and Senior Registrars (SR) (PGY7+); collectively described as trainees.

Results: A total of 53 (20.7%) of 256 appendicectomies were trainee as trainer (TT) cases; 22 cases (41.5%) were performed by a CT supervised by a Registrar, and 31 (58.4%) by a JR supervised by a SR. Among the cases, 17 (32.1%) were complex, 47 (88.7%) were in working hours (8am-5pm), and 50 (94.3%) took place Monday to Friday. Median (interquartile range) duration of surgery was 65 (52-77) minutes. In the first year, 60 (47%) appendicectomies were performed by JRs. JR 1 was TT in three cases (8.8%) and JR 2 in five cases (19.2%); in all cases, the learner was a CT. Overall, there were 26 (10.6%) negative appendicectomies, 8 (3%) conversions, 19 (7%) readmissions within 30 days of discharge and 3 (1.1%) required reoperation; there was no statistically significant difference in complications between TT and non-TT cases.

Conclusion: Laparoscopic appendicectomy is an excellent model for trainees to act as trainer; case selection included simple cases during daylight hours. Our outcomes are comparable with published literature, suggesting that this teaching method is safe for patients.

在儿科腹腔镜阑尾切除术中担任培训员。
背景:术中教学是一项基本的外科技能,但有关受训者担任培训者的文献很少:术中教学是一项基本的外科技能,但有关受训者担任培训师的文献却很少;我们对小儿腹腔镜阑尾切除术中的这些病例进行了分析:这是一项对英国一家三级儿科外科中心两年来(2015-2017年)病例记录的回顾性研究。操作人员包括:儿外科核心受训人员(CT)(研究生年级(PGY)3-4)、初级注册医师(JR)(PGY5-6)和高级注册医师(SR)(PGY7+);统称为受训人员:在256例阑尾切除术中,共有53例(20.7%)是由受训者担任培训师(TT)的病例;22例(41.5%)由注册医师指导的CT实施,31例(58.4%)由注册医师指导的JR实施。在这些病例中,17 例(32.1%)为复杂病例,47 例(88.7%)在工作时间(上午 8 时至下午 5 时)内进行,50 例(94.3%)在周一至周五进行。手术时间中位数(四分位数间距)为 65(52-77)分钟。第一年中,有 60 例(47%)阑尾切除手术由联合医务人员完成。JR 1 是 TT 的有 3 例(8.8%),JR 2 是 TT 的有 5 例(19.2%);在所有病例中,学习者都是 CT。总体而言,有26例(10.6%)阑尾切除术结果为阴性,8例(3%)转为阳性,19例(7%)在出院后30天内再次入院,3例(1.1%)需要再次手术;TT和非TT病例的并发症差异无统计学意义:结论:腹腔镜阑尾切除术是一种很好的培训模式,可作为受训者的培训教材;病例选择包括白天的简单病例。我们的结果与已发表的文献相当,表明这种教学方法对患者是安全的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.40
自引率
0.00%
发文量
316
期刊介绍: The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.
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