A multimethod assessment of the vascular surgery program director experience in creating effective training environments.

IF 3.6 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Margaret A Reilly, Christina L Cui, Yue Jiang, Eric B Pillado, Ruojia Debbie Li, Joshua S Eng, Leanne E Grafmuller, Kathryn L DiLosa, Palma M Shaw, Yue-Yung Hu, Karl Y Bilimoria, Dawn M Coleman, Malachi G Sheahan
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引用次数: 0

Abstract

Objective: Surgical training has received significant attention in recent years with efforts to improve trainee wellness. Vascular surgery training is subject to unique challenges, and vascular program directors (PDs) are tasked with providing learning environments that produce effective and competent surgeons. The aim of this study was to examine the experience of vascular surgery PDs in promoting effective learning environments for vascular trainees.

Methods: Data were collected from confidential, voluntary surveys of vascular surgery residency PDs with multiple choice and free response questions as part of the Surgical Education Culture Optimization Through Targeted Interventions based on National Comparative Data (SECOND) trial. PDs were asked about their use of wellness interventions, resources available through their institution, and resources still required. PDs indicated the most rewarding and challenging aspects of their role. Program-level wellness data were aggregated from trainee responses to an annual survey of trainee wellness. Associations between program wellness metrics and the number of interventions used by PDs were assessed with Wilcoxon rank-sum tests. Qualitative data were analyzed with inductive reasoning to identify themes.

Results: Of 33 PDs who participated in the survey (76.7% of programs enrolled in the Vascular SECOND trial), most PDs had opportunities to engage with other faculty (n = 27 [81.8%]), support from Graduate Medical Education (n = 27 [81.8%]), and administrative support from program coordinators (n = 26 [78.8%]). Many PDs reported a need for additional salary/stipend support to incentivize program leadership (n = 23 [69.7%]), funded protected effort to decrease clinical responsibilities (n = 18 [54.6%]), and discretionary educational funds (n = 13 [39.4%]). The trainee-related issues most frequently encountered by PDs were performance challenges (n = 15 [45.5%]) and interpersonal issues between trainees and ancillary staff (n = 9 [27.3%]). The most common institutional-level issues were incongruence between hospital administration goals and clinical priorities (n = 9 [27.3%]) and protected time for administrative responsibilities (n = 8 [24.2%]). There were no significant associations between trainee wellness and perception of program responsiveness or resources needed or available to PDs. Themes of the most rewarding aspects of the PD job were participating in trainee growth, training the next generation, and interpersonal relationships. Themes of most challenging aspects were generational differences, interpersonal challenges, lack of resources, and administrative tasks.

Conclusions: Vascular surgery PDs assume a challenging role with unique responsibilities. Certain barriers and facilitators of wellness may be experienced by a majority of PDs, which allows for identification of potentially widely effective interventions. Ultimately, supporting PD efforts should focus on improving resources like funded protected efforts and reducing administrative burden.

多方法评估血管外科项目主任在创造有效培训环境方面的经验。
目的:近年来,外科培训受到了极大的关注,努力提高学员的健康水平。血管外科培训面临着独特的挑战,血管项目主任(pd)的任务是提供培养有效和有能力的外科医生的学习环境。本研究的目的是探讨血管外科医师在促进血管实习生有效学习环境方面的经验。方法:数据收集自血管外科住院医师的保密自愿调查,其中包含多项选择和自由回答问题,作为第二次试验的一部分。pd被问及他们对健康干预措施的使用情况、他们所在机构提供的资源以及仍然需要的资源。pd指出了他们的角色中最有价值和最具挑战性的方面。项目层面的健康数据是根据学员对年度健康调查的反馈进行汇总的。采用Wilcoxon秩和检验评估项目健康指标与pd使用的干预措施数量之间的关联。定性数据分析归纳推理,以确定主题。结果:在参与调查的33名项目主任中(76.7%的项目参加了血管二次试验),大多数pd有机会与其他教员(N=27, 81.8%)、研究生医学教育(N=27, 81.8%)和项目协调员的行政支持(N=26, 78.8%)接触。许多博士报告需要额外的工资/津贴支持来激励项目领导(N=23, 69.7%),资助保护工作以减少临床责任(N=18, 54.6%),以及酌情教育基金(N=13, 39.4%)。pd最常遇到的学员相关问题是绩效挑战(N=15, 45.5%)和学员与辅助人员之间的人际关系问题(N=9, 27.3%)。最常见的机构层面问题是医院管理目标与临床优先事项之间的不一致(N=9, 27.3%),以及行政责任的保护时间(N=8, 24.2%)。受训者的健康状况与项目反应性或pd所需或可用资源的感知之间没有显著的关联。PD工作中最有价值的方面是参与培训生成长、培训下一代和人际关系。最具挑战性的主题是代际差异、人际挑战、缺乏资源和管理任务。结论:血管外科医师承担着具有挑战性的角色和独特的责任。大多数pd可能会遇到某些健康障碍和促进因素,从而可以确定可能广泛有效的干预措施。最终,支持PD工作应侧重于改善资源,如资助保护工作和减少行政负担。
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
7.70
自引率
18.60%
发文量
1469
审稿时长
54 days
期刊介绍: Journal of Vascular Surgery ® aims to be the premier international journal of medical, endovascular and surgical care of vascular diseases. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. To acheive this goal, the Journal will publish original clinical and laboratory studies, and reports and papers that comment on the social, economic, ethical, legal, and political factors, which relate to these aims. As the official publication of The Society for Vascular Surgery, the Journal will publish, after peer review, selected papers presented at the annual meeting of this organization and affiliated vascular societies, as well as original articles from members and non-members.
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