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整体外科住院医生 核心血管外科手术程序中的能力和自主权
Taylor M Carter1, M Libby Weaver2, Ting Sun3
1Office of Surgical Education, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Journal of surgical education
|January 22, 2025
概括
整体外科住院医生 (GSR) 在核心血管手术中扎,在动脉静脉囊形成和下肢截肢方面表现出较低的能力. 培训需要重新评估血管外科技能.
科学领域:
- 血管外科培训 血管外科培训
- 整体外科教育教育 一般外科教育
- 外科手术能力评估的评估.
背景情况:
- 血管外科子专业化提出了关于一般外科住院医生 (GSR) 能力的问题.
- 了解GSR在重要血管程序中的能力至关重要.
研究的目的:
- 评估一般外科医生在执行核心血管外科手术过程中的能力和自主性.
- 为了评估下肢截肢,动脉静脉形成和下肢栓塞/血栓切除术的表现.
主要方法:
- 分析了2018-2022年期间从程序学习改进和测量系统 (SIMPL) 中进行的1950次操作评估.
- 利用描述性统计,奇方测试和物流通用线性混合模型 (GLMM).
- 专注于三个核心血管程序:LE截肢,AVF创建和LE血栓栓切除术.
主要成果:
- 高龄居民在LE截肢方面表现出高能力 (82%) 和自主性 (66%).
- 在创建AVF时,能力 (50%) 和自主性 (32%) 较低.
- 大多数老年居民在LE血栓栓切除术中缺乏能力 (80%) 和自主性 (67%).
- 在所有三种程序中,初级和中级居民表现出有限的能力和自主性.
结论:
- 一般外科住院医生 (GSR) 在关键的血管程序 (如AVF创建) 中经常无法获得能力和自主性.
- 目前的培训可能没有充分准备GSR进行血管外科的委托,特别是创建AVF,一个新的可信任的专业活动 (EPA).
- 建议重新评估通用外科的血管外科住院培训要求.
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