Back to basics – The importance of enterostomal therapy education for general surgery residents

John J. Tackett, Annabelle L. Fonseca, W. Longo
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Abstract

Background and Objectives: General surgery residents' perceived knowledge base and comfort with intestinal stomas and enterostomal therapy are profiled through a national survey. Subjects and Methods: General surgery residents were surveyed to explore the existence of formal didactics and training in ostomy creation and stomal care, to examine the residents' perceived knowledge base of clinical indications for enterostomal care approaches, and to elicit the residents' comfort with performing enterostomal surgeries and managing complications. Results: A total of 734 US residents were surveyed. 218 respondents completed the survey (30%): 40% Northeast, 22% Midwest, 22% South, 16% West, and 82% with direct university affiliation. Only 12% experienced formal enterostomal therapy training and only 15% attended related lectures. Most (86%) routinely worked with enterostomal therapists. Only 11% of chiefs felt “very confident” in their knowledge base of clinical indications for enterostomal care, and 61% felt “very comfortable” with surgical procedures of ostomy creation and closure. Merely 4% of all residents felt “very comfortable” dealing with common ostomy complications. Conclusions: In an era of surgical subspecialization and advanced nursing practice in enterostomal therapy, general surgery residents lack confidence in their knowledge base and comfort when approaching enterostomal therapy and stomal complications. US resident education should be reformed to enhance training in these fundamental principles essential to general surgery practice.
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回归基础-肠造口治疗教育对普外科住院医师的重要性
背景和目的:通过一项全国性调查,了解普通外科住院医师对肠造口和肠造口治疗的感知知识基础和舒适度。受试者和方法:对普通外科住院医师进行调查,以探索造口术创建和造口护理方面是否存在正式的教学和培训,检查住院医师对肠造口护理方法临床适应症的感知知识库,并引导住院医师对进行肠造口手术和管理并发症感到舒适。结果:共有734名美国居民接受了调查。218名受访者完成了这项调查(30%):40%为东北部,22%为中西部,22%为南部,16%为西部,82%为直接大学附属。只有12%的人接受过正式的肠造口治疗培训,只有15%的人参加过相关讲座。大多数人(86%)经常与肠造口治疗师合作。只有11%的酋长对他们的肠造口护理临床适应症知识库感到“非常有信心”,61%的酋长对造口术的创建和闭合手术程序感到“非常舒服”。只有4%的居民在处理常见的造口术并发症时感到“非常舒服”。结论:在肠造口治疗的外科亚专业化和高级护理实践时代,普通外科住院医师在处理肠造口治疗和造口并发症时,对自己的知识基础和舒适度缺乏信心。美国住院医师教育应该进行改革,以加强对这些基本原则的培训,这些原则对普通外科实践至关重要。
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