在历史中屈服? 探讨美国外科手术委员会核心程序的衰落
Brendan P Stewart1, Maximillian D Shlafstein2, Alyson S Cunningham1
1Department of General Surgery, UConn Health Center, Farmington, CT.
分析了整体外科的核心课程程序. 低体积的手术,如囊管切除术和阴道切除术,正在下降,这表明需要对高级培训水平进行重新评估.
科学领域:
- 外科教育的外科教育
- 医疗培训 医学培训
- 课程开发 课程开发
背景情况:
- 美国外科医学会 (American Board of Surgery) 在一般外科住院的6个核心能力范围内授权近150次手术.
- 研究生医学教育认证委员会 (ACGME) 制定了外科培训的标准.
- 需要对核心课程程序进行分析,以确定那些适合高级分类的程序.
研究的目的:
- 分析整体外科的核心课程程序.
- 在核心课程中识别低量流程.
- 确定某些程序是否应该重新分类到高级或奖学金级别.
主要方法:
- 审查了整体外科的核心课程程序,重点是囊管切除术,阴道切除术和常见胆道探索.
- 利用美国外科医生学院国家外科质量改进计划数据库 (2012-2023).
- 程序案件数量与毕业的首席医师数量和ACGME国家案例日志进行了比较.
主要成果:
- 腹腔镜检查普通胆道检查显示,从2012年到2023年,病例数量增长最快.
- 每位毕业的首席住院医生所需的手术减少了:囊管切除 (0.03至0.02),阴道切除 (0.12至0.06) 和开放的普通胆道探索 (0.18至0.09).
- 在2023年,很少有居民进行了囊管切除术,阴道切除术或开放的普通胆道探索.
结论:
- 核心课程程序需要仔细审查.
- 低量流程需要重新评估,以考虑可能的移除或提升到高级/奖学金级别.
- 这种分析可以为通用外科住院培训的课程改进提供信息.
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