外科和程序培训中的学习者交接:指导的连续性还是声誉的污染?叙述性评论

IF 3.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Amna Qamar, Robert M Maweni
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引用次数: 0

摘要

目的:学习者交接是指与学习者相关的信息在主管、轮岗或教育阶段之间的传递。这篇叙述性的综述研究了外科和程序培训中的学习者移交,包括外科、介入心脏病学、介入放射学和胃肠内窥镜,在这些培训中,关于先前表现的信息可能会影响委托、监督、病例分配和技术机会。结果:学习者移交被认为是一种缓解轮转培训中固有的不连续性的方法,可以实现更早、更有针对性的指导。然而,对先前表现信息的实证研究表明,在观察学习者之前,评估者可能会受到他们被告知的内容的影响,并描述了同化和对比效应。学习者报告说,当他们不知道分享什么、由谁分享、出于什么目的时,交接可能会让他们感到不透明、焦虑和声誉风险。在程序性专业中,这些担忧被放大,因为声誉信息可能会改变对稀缺病例的访问,实际参与的门槛以及在侵入性任务期间授予的监督水平。结论:既不能不加批判地接受学习者移交,也不能直接拒绝学习者移交。外科手术和程序性方案应取代非正式的声誉交换,代之以结构化的发展交接,这种交接在行为上是具体的、最近的、相称的、以学习者为中心的、有时间限制的,并与明确的指导行动相联系。核心任务是保持培训的连续性,同时防止声誉受损。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Learner handover in surgical and procedural training: continuity of coaching or reputational contamination? A narrative review.

Purpose: Learner handover is the transfer of learner-related information between supervisors, rotations or educational phases. This narrative review examines learner handover in surgical and procedural training, including surgery, interventional cardiology, interventional radiology and gastrointestinal endoscopy, where information about prior performance may influence entrustment, supervision, case allocation and technical opportunity.

Results: Learner handover has been proposed as a way to mitigate the discontinuity inherent in rotational training and to enable earlier, more targeted coaching. However, empirical work on prior performance information shows that assessors can be influenced by what they are told before observing a learner, with both assimilation and contrast effects described. Learners report that handover can feel opaque, anxiety-provoking and reputationally risky when they do not know what is shared, by whom or for what purpose. In procedural specialties these concerns are amplified because reputational information may alter access to scarce cases, thresholds for hands-on participation and the level of supervision granted during invasive tasks.

Conclusion: Learner handover should neither be adopted uncritically nor rejected outright. Surgical and procedural programmes should replace informal reputational exchange with structured developmental handover that is behaviourally specific, recent, proportionate, learner-centred, time-limited and linked to explicit coaching actions. The central task is to preserve continuity of coaching while preventing reputational contamination.

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来源期刊
Postgraduate Medical Journal
Postgraduate Medical Journal 医学-医学:内科
CiteScore
8.50
自引率
2.00%
发文量
131
审稿时长
2.5 months
期刊介绍: Postgraduate Medical Journal is a peer reviewed journal published on behalf of the Fellowship of Postgraduate Medicine. The journal aims to support junior doctors and their teachers and contribute to the continuing professional development of all doctors by publishing papers on a wide range of topics relevant to the practicing clinician and teacher. Papers published in PMJ include those that focus on core competencies; that describe current practice and new developments in all branches of medicine; that describe relevance and impact of translational research on clinical practice; that provide background relevant to examinations; and papers on medical education and medical education research. PMJ supports CPD by providing the opportunity for doctors to publish many types of articles including original clinical research; reviews; quality improvement reports; editorials, and correspondence on clinical matters.
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