目的:对于准备从事普外科职业的学生来说,外科实习是重要的轮换;但是,这些轮换通常因机构和服务而异。这项改良的德尔菲研究是为了达成一组共识的角色,责任,以及四年级医学生对外科实习的期望。
方法:关于角色的候选陈述,责任,亚实习生的期望分为7个领域:轮换结构,四舍五入和病人护理,手术室行为,技术技能,知识库,诊所,和专业性。专家小组由主要利益相关者组成:项目主管,职员主管,其他教育学院,学员,和最近的副实习生。2023年1月至4月进行了三轮Delphi回合,以达成共识,先验定义为Cronbachα≥0.8和80%或更高的小组协议。
结果:招募了46名专家小组成员参加Delphi回合,100%,95.7%,第一次反应率为97.8%,第二,第三轮,分别。到了第三轮,67项声明作为基本作用达成共识,责任,以及对外科副实习生的期望。这67项声明中的主要主题包括副实习生在工作时间方面近似实习生的作用,患者护理责任,基本技术技能,和知识库。小组成员将舍入和患者护理评为最重要的领域,紧随其后的是专业精神。按降序排列的其他关键评估领域是知识库,手术室行为,诊所,和技术技能。到了第三轮,德尔福流程中的显著分歧包括技术技能、四舍五入和病人护理(93.3%和88.9%同意,分别)。
结论:这项研究为核心角色提供了全国共识,责任,以及对医学生完成外科实习的期望。学生可以使用这些建议来准备子实习,而教师以及居民和研究员可以使用它们来评估申请人的普通外科住院医师职位。
OBJECTIVE: Surgical subinternships are important rotations for students preparing for a career in general surgery; however, these rotations often vary by institution and service. This modified Delphi study was conducted to reach a
consensus set of roles, responsibilities, and expectations of fourth-year medical students on their surgical subinternships.
METHODS: Candidate statements on roles, responsibilities, and expectations of subinterns were categorized into 7 domains: rotation structure, rounding and patient care, operating room conduct, technical skills, knowledge base, clinic, and professionalism. Expert panels were assembled of key stakeholders: program directors, clerkship directors, other education faculty, trainees, and recent subinterns. Three Delphi rounds were conducted from January to April 2023 to reach
consensus defined a priori as a Cronbach α ≥ 0.8 and 80% or greater panel agreement.
RESULTS: Forty-six expert panelists were recruited to participate in Delphi rounds, with 100%, 95.7%, and 97.8% response rates in the first, second, and third rounds, respectively. By the third round, 67 statements reached
consensus as essential roles, responsibilities, and expectations of surgical subinterns. Key themes from these 67 statements included subinterns approximating the role of an intern with respect to work hours, patient care responsibilities, basic technical skills, and knowledge base. Panelists rated rounding and patient care as the most important domain, followed closely by professionalism. Additional key domains for evaluation in descending order were knowledge base, operating room conduct, clinic, and technical skills. By the third round, notable disagreements in the Delphi process included technical skills and rounding and patient care (93.3% and 88.9% agreement, respectively).
CONCLUSIONS: This study provides a national
consensus on core roles, responsibilities, and expectations for medical students completing surgical subinternships. Students can use these recommendations to prepare for subinternships, whereas faculty as well as residents and fellows can use them to evaluate applicants for general surgery residency positions.