图3.6新冠肺炎期间外科培训抢救:医院质量视角

O. Luton, K. Mellor, C. Eley, W. Lewis, R. Egan
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引用次数: 0

摘要

新冠肺炎疫情期间,重新部署、取消选课和远程教育活动等变化限制了培训机会。本研究旨在分析COVID对全球高等外科培训生(HST)绩效指标的影响,包括医院适应性和方差。材料和方法对50名HSTs(中位年龄36(29-46岁),女性15岁,男性35岁)的校际外科课程计划(ISCP)组合进行分析,其中包括191个六个月的轮岗实习(2019年3月至2021年)。主要效果测量是:操作日志编号,根据课程要求验证的索引程序和基于工作的评估(WBA)。结果在新冠肺炎期间,每次手术经验下降26.1%(中位数211比156,p<0.010),实习初级外科医生经验下降32.1%(162比110,p<0.010)。关于指标手术:胆囊切除术下降45.5%(11比6,p=0.027),腹股沟疝下降62.5%(8比3,p<0.010)。wba相似(17比13,p=0.364)。区级综合医院(DGH, n=65)的总手术次数中位数比三级医院(TH, n=110, p<0.010)少40.9%。复合指标的雷达图覆盖率在冠状病毒前为11.1 - 75.6% (p=0.011),而冠状病毒后为13.3 - 68.9% (p=0.015)。医院培训指标的差异超过五倍,这一差异可能因COVID而被放大,这更适用于存在的共享经验教训。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
TU3.6 Surgical training salvage during COVID-19: a hospital quality perspective
Abstract Introduction Vicissitudes including re-deployment, elective cancellations, and remote educational events have restricted training opportunities during the COVID pandemic. This study aimed to analyse COVID's impact on global Higher Surgical Trainee (HST) performance metrics including hospital adaptability and variance. Materials and Method Intercollegiate Surgical Curriculum Programme (ISCP) portfolios of 50 HSTs (median age 36 (range 29–46) yr., female 15, male 35), including 191 six-month rotational placements, were analysed over two years (March 2019 to 2021). Primary effect measures were: operative logbook numbers, index procedures validated against curriculum requirements and Work Based Assessments (WBA). Results During COVID-19, operative experience per placement declined 26.1% (median 211 vs. 156, p<0.010), with a 32.1% decline in trainee primary surgeon experience (162 vs. 110, p<0.010). Regarding index procedures: cholecystectomy declined 45.5% (11 vs. 6, p=0.027) and inguinal hernia 62.5% (8 vs. 3, p<0.010). WBAs were similar (17 vs. 13, p=0.364). Despite relative equivalence before COVID, median total number of operative procedures performed in District General Hospitals (DGH, n=65) were 40.9% fewer than Tertiary Hospitals (TH, n=110, p<0.010). Radar plots of composite metrics ranged from 11.1 to 75.6% coverage before (p=0.011) vs. 13.3 to 68.9% after COVID (p=0.015). Discussion Hospital training metrics varied over five-fold, a difference likely amplified by COVID, with THs more adaptable to existential shared lessons.
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