目标:传统上,专家外科医生已向手术学员提供有关其模拟性能的反馈,包括异步练习。不幸的是,无数的时间需求可能会限制专家提供反馈的能力。尚不清楚同伴反馈是否以及如何在异步环境中帮助居民获得腹腔镜技能的有效机制。因此,我们旨在评估同伴反馈对腹腔镜检查表现的影响,并确定住院医师对给予和接受同伴反馈的看法.
方法:我们进行了会聚混合方法研究。在定量成分中,我们将住院医师随机分组,以接收来自同行或教师的关于家庭腹腔镜任务的反馈.然后我们举行了课程结束,对来自两组的成员进行面对面腹腔镜评估,并比较两组间面对面评估的表现.在定性部分,我们对常驻参与者进行了访谈,以探索反馈和绩效方面的经验。三位作者使用定向内容分析对访谈数据进行了编码和严格审查。
方法:我们在一个高等教育机构进行了这项研究:加州大学,旧金山.
方法:我们邀请了47名普外科初级住院医师,妇产科,和泌尿科参与,其中37人(79%)参加了家庭课程,25人(53%)参加了课程结束评估。
结果:同伴反馈组的居民在最终评估中的得分与教师反馈组的居民(平均71.8%;SD11.9%)相似(p=0.86)。通过对13名居民的访谈进行定性分析,我们确定了同伴反馈功效的关键原因:共享心智模型,头脑风暴和欣赏新方法的能力,和低风险的学习环境。
结论:我们发现,同伴和教师的反馈导致基本腹腔镜检查的类似表现,并且居民积极地参与同伴的反馈,建议当居民学习基本的腹腔镜检查时,可以使用同伴反馈。
OBJECTIVE: Traditionally, expert surgeons have provided surgical trainees with feedback about their simulation performance, including for asynchronous practice. Unfortunately, innumerable time demands may limit experts\' ability to provide feedback. It is unknown whether and how peer feedback is an effective mechanism to help residents acquire laparoscopic skill in an asynchronous setting. As such, we aimed to assess the effect of peer feedback on laparoscopic performance and determine how residents perceive giving and receiving peer feedback.
METHODS: We conducted a convergent mixed methods study. In the quantitative component, we randomized residents to receive feedback on home laparoscopic tasks from peers or faculty. We then held an end-of-curriculum, in-person laparoscopic assessment with members from both groups and compared performance on the in-person assessment between the groups. In the qualitative component, we conducted interviews with resident participants to explore experiences with feedback and performance. Three authors coded and rigorously reviewed interview data using a directed content analysis.
METHODS: We performed this study at a single tertiary academic institution: the University of California, San Francisco.
METHODS: We invited 47 junior residents in general surgery, obstetrics-gynecology, and urology to participate, of whom 37 (79%) participated in the home curriculum and 25 (53%) participated in the end-of-curriculum assessment.
RESULTS: Residents in the peer feedback group scored similarly on the final assessment (mean 70.7%; SD 16.1%) as residents in the faculty feedback group (mean 71.8%; SD 11.9%) (p = 0.86). Through qualitative analysis of interviews with 13 residents, we identified key reasons for peer feedback\'s efficacy: shared mental models, the ability to brainstorm and appreciate new approaches, and a low-stakes learning environment.
CONCLUSIONS: We found that peer and faculty feedback led to similar performance in basic laparoscopy and that residents engaged positively with peer feedback, suggesting that peer feedback can be used when residents learn basic laparoscopy.