Protected Educational Rotations: A Valuable Paradigm Shift in Surgical Internship

作者：Tillou Areti^*; Hiatt Jonathan R; Leonardi Michael J; Quach Chi; Hines O Joe

来源：Journal of Surgical Education, 2008, 65(6): 465-469.

DOI：10.1016/j.jsurg.2008.07.012

• internship
• medical education
• residency training
• surgical rotation

OBJECTIVE: The first year of surgical training sometimes includes marginally educational or service-related tasks with limited direct interactions with faculty. We instituted a prototype rotation to address the changing needs and expectations of our intern class. This study was designed to evaluate the new rotation 17 months after it was implemented.
DESIGN: Interns spend 4 weeks in our outpatient surgery center. Elements of the rotation include performance of operative cases and perioperative management of outpatients under direct faculty supervision, daily one-on-one structured teaching sessions with faculty, and call coverage twice monthly. At the conclusion of the rotation, interns make a presentation on a topic of their choosing to a reaching conference. Rotation evaluations and case and work-hour logs for the outpatient surgery, rotation (OSR) were compared with those for the remaining intern rotations combined. A faculty survey of the OSR also was conducted.
RESULTS: The OSR consistently, received maximum overall ratings (4 of 4), significantly higher than the average overall score for the remaining rotations (3.17, p < 0.01). Similarly, teaching by faculty, rime spent in the operating room, and quality of operating room time were rated significantly higher than for the other intern rotations (p <= 0.05). Interns performed an average of 44 cases in 4 weeks of OSR, compared with an average of 94 in the remaining rotations (p < 0.001), and they worked an average of 62 hours per week (range, 49-76 hours). Of the participating faculty, 93% reported that the interaction gave them the opportunity to know the interns better at a personal level, that the sessions were beneficial and improved working relationships with interns, and that the program should continue.
CONCLUSIONS: Changing program requirements, time restrictions, public scrutiny, and increasing awareness for quality of life all obligate a paradigm shift in surgical education. Our outpatient rotation is logistically simple and rewarding both for residents and faculty. (J Surg 65:465-469.

• 出版日期2008-12