目的:关于第三方缺席的八卦评估性讨论存在于外科住院医师计划中。主治医生可能会八卦,为住院医师提供绩效反馈,这可能会导致偏见。然而,主治医生对八卦的看法尚未得到研究。
方法:在这项定性研究中,与主治医生进行了关于外科培训八卦的半结构化访谈。我们用扎根的理论方法对成绩单进行了反身性主题分析,以描述主治医生对他们在外科住院医师中八卦中的作用的看法。
方法:采访于2023年9月23日至2023年11月27日通过Zoom™进行。
方法:对与7项手术培训项目相关的18名手术患者进行了访谈。
结果:开发了六个主题:1)听众通常用负镜头观看八卦;因此,关于符合八卦学术定义的居民表现的善意对话不会被视为八卦;2)八卦会损害主治医生和教育工作者的声誉;3)通过保持准确和客观的诚实沟通标准来减轻八卦的负面影响是困难的;4)在制定自己的意见之前,出席者对听到其他出席者的印象表示担忧;5)这可能会限制他们对节目文化的了解;和6)在节目层面很难减轻八卦。最终,出席者利用八卦(例如三角化他们的经验),目的是向居民提供反馈。
结论:将关于住院医师表现的重要对话定义为八卦不应阻止这些至关重要的对话,而应通过3种行为强调与有害八卦作斗争的重要性:1)致力于客观交流;2)限制或重新定义与尚未形成自己意见的主治人员共享的住院医师表现信息;3)在特定的高风险微环境(例如手术室)中规范八卦。
OBJECTIVE: Gossip-evaluative talk about an absent third party-exists in surgical residency programs. Attending surgeons may engage in
gossip to provide residents with feedback on performance, which may contribute to bias. Nevertheless, the perspectives of attending surgeons on
gossip has not been studied.
METHODS: In this qualitative study, semi-structured interviews about
gossip in surgical training were conducted with attending surgeons. We performed a reflexive thematic analysis of transcripts with a grounded theory approach to describe attendings\' perceptions of their role in gossip within surgical residency.
METHODS: Interviews were conducted from September 23, 2023, to November 27, 2023 via Zoom™.
METHODS: Eighteen surgery attendings associated with 7 surgical training programs were interviewed.
RESULTS: Six themes were developed: 1) Attendings typically view gossip with a negative lens; thus, well-intended conversations about resident performance that meet the academic definition of gossip are not perceived as
gossip; 2)
Gossip can damage attendings\' reputations as surgeons and educators; 3) Mitigating the negative impacts of gossip by maintaining accurate and objective standards of honest communication is hard; 4) Attendings express concerns about hearing other attendings\' impressions of residents prior to formulating their own opinion; 5) The surgical hierarchy restricts the volume and content of gossip that reaches attendings, which may limit their knowledge of program culture; and 6) It is very difficult to mitigate gossip at the program level. Ultimately, attendings utilize gossip (e.g. triangulating their experience) with the goal of providing residents feedback.
CONCLUSIONS: Defining important conversations about resident performance as gossip should not discourage these critically important conversations but rather underscore the importance of combating harmful gossip through 3 behaviors: 1) committing to objective communication; 2) limiting or reframing information about resident performance that is shared with attendings who have yet to formulate their own opinions; and 3) regulating gossip in particular high-stakes microenvironments (e.g. the operating room).