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合适的案例,合适的时间:哪些程序最能区分一般外科实习生的手术表现?
Rebecca Moreci1, Rebecca S Gates1, Kayla M Marcotte2
1Department of Surgery, Center for Surgical Training and Research, University of Michigan, Ann Arbor, Michigan.
Journal of surgical education
|June 22, 2023
概括
识别关键的外科手术程序可以改善学员评估. 这项研究发现,特定的高体积手术最能在整体外科研究生年度 (PGY) 水平上区分表现,提高评估效率.
科学领域:
- 医学教育 医学教育
- 手术培训评估的评估
- 绩效指标 绩效指标 是一个指标.
背景情况:
- 外科住院医生的手术绩效评估是资源密集的.
- 优化评估需要确定最能为学员表现提供最佳信息的程序.
- 目前的方法可能无法有效地确定在研究生年级 (PGY) 的技能差异.
研究的目的:
- 确定特定的外科手术程序,有效地区分每个一般外科手术PGY水平的手术性能.
- 为外科住院的有针对性的评估策略提供数据驱动的建议.
主要方法:
- 使用了来自改善医学专业学习协会 (SIMPL) 的操作性绩效评级协作.
- 应用了多层次的Rasch模型来识别每个PGY级别的高和低绩效学员.
- 根据高与低绩效人员的"实践准备"评级计算了一项程序性绩效歧视指数.
主要成果:
- 分析了来自70个普通外科住院计划 (2015-2021) 的54,790项评估.
- 每个PGY级别为51-105个程序生成的歧视值.
- 确定了12个 (PGY1),15个 (PGY2),22个 (PGY3),21个 (PGY4) 和28个 (PGY5) 的"高度差异化,大量"程序.
结论:
- 国家数据揭示了在每个PGY级别中最能区分外科实习生的表现的程序.
- 一个精心策划的高差异化,高体积程序列表可以指导有针对性的评估.
- 实施这些发现可以提高外科培训评估的效率和有效性.
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