[新的继续教育规定--内脏外科面临的挑战:DGAV成员的调查结果和青年外科医生的解决策略]。

Chirurgie (Heidelberg, Germany) Pub Date : 2024-07-01 Epub Date: 2024-04-26 DOI:10.1007/s00104-024-02082-1
Josefine Schardey, Florentine Hüttl, Anne Jacobsen, Stefanie Brunner, Verena Tripke, Ulrich Wirth, Jens Werner, Jörg C Kalff, Nils Sommer, Tobias Huber
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引用次数: 0

摘要

背景:新的基于能力的外科培训进修条例(nWBO)已被德国各州医学会采纳:2023年5月至6月,青年外科医生工作组(CAJC)对德国普通与内脏外科学会(DGAV)的5896名会员进行了匿名在线调查:调查的目的是评估对 nWBO 的期望,并制定加强外科培训的策略:这项研究共有 488 人参与(回复率为 8.3%),具有一定的代表性。受访者包括 107 名继续教育助理(WBA 21.9%)、69 名专科医生、188 名高级医生(专科医生 14.1%,高级医生 38.5%)以及 107 名主任医师(21.9%)。大多数人在正规医疗机构工作(44%),其次是最高级医疗机构(26.8%)和大学诊所(20.1%)。只有 22% 的受访者认为新的专科医师培训条例(nWBO)所要求的手术范围是现实的。半数受访者认为,根据新目录在其诊所进行全面培训将不再可能,54.6%的受访者认为在 6 年内实现目标人数是不可能的,或表示他们无法在相同的时间框架内培训相同数量的继续教育助理(WBAs)。内窥镜检查(17.1%-18.8%)、胃底折叠术(15.4%-17.7%)和头颈部手术(12.1%-17.1%)一直被认为是各级医疗机构的瓶颈。据报告,64.7%的医院已经建立了平衡轮转或没有必要建立平衡轮转。48%的人表示科室已经建立了部分步骤概念。85%的WBA认为结构化培训概念很重要,而53.3%的主任医师(CÄ)认为结构化培训概念很重要。在单变量分析中,如果科室中存在结构化培训理念,则目标人数的可实现性会得到更积极的评价。在多变量分析中,男性性别和 "专业医师/教授 "身份是影响对全国妇女健康组织更积极评价的独立因素。51.5%的人认为客观的培训认证很重要:结论:人们对《国家妇女行动计划》表示担忧和悲观。额外的要求和医院改革可能会使情况更加恶化。合作和轮转至关重要,但仍未得到充分实施。以质量为导向的认证可以提高培训质量。
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[The new continuing education regulations-A challenge for visceral surgery : Results of a survey among DGAV members and solution strategies of the Young Surgeons].

Background: The new competency-based further training regulations (nWBO) for surgical training have been adopted by all German state medical associations.

Methods: From May to June 2023 the Young Surgeons' Working Group (CAJC) conducted an anonymous online survey among the 5896 members of the German Society for General and Visceral Surgery (DGAV).

Objective: The survey aimed to assess expectations regarding the nWBO and to develop strategies for enhancing surgical training.

Results: With 488 participants (response rate 8.3%) the study is representative. The respondents consisted of 107 continuing education assistants (WBA 21.9%), 69 specialist physicians, and 188 senior physicians (specialist physicians 14.1% and senior physicians 38.5%), as well as 107 chief physicians (21.9%). The majority worked in regular care providers (44%), followed by maximum care providers (26.8%) and university clinics (20.1%). Only 22% considered the required operative spectrum of the new medical specialist training regulations (nWBO) to be realistic. Half of the respondents believed that full training in their clinic according to the new catalog will no longer be possible and 54.6% considered achieving the target numbers in 6 years to be impossible or state that they can no longer train the same number of continuing education assistants (WBAs) in the same time frame. Endoscopy (17.1-18.8%), fundoplication (15.4-17.7%) and head and neck procedures (12.1-17.1%) were consistently mentioned as bottlenecks across all levels of care. Rotations for balance were reported to be already established or not necessary in 64.7%. In 48% it was stated that the department had established the partial steps concept. The importance of a structured training concept was considered important by 85% of WBAs, compared to 53.3% of chief physicians (CÄ). If a structured training concept was present in the department, the achievability of the target numbers was significantly assessed more positively in the univariate analysis. In the multivariate analysis, male gender and the status of "habilitated/professor" were independent factors for a more positive assessment of the nWBO. Objective certification of training was considered important by 51.5%.

Conclusion: Concerns surround the nWBO and the sentiment is pessimistic. Additional requirements and hospital reforms could exacerbate the situation. Collaboration and rotations are crucial but still insufficiently implemented. Quality-oriented certification could enhance the quality of training.

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Klinische Studien. S2k-Leitlinie „Behandlung thermischer Verletzungen im Kindesalter“. [Trauma-associated vascular injuries and the vascular surgical/interventional options for vascular reconstruction]. ["Surgical foresight: beyond the routine" : The challenge of complex visceral surgical emergencies for young medical specialists and senior physicians]. [Conversion to outpatient treatment beyond the hybrid DRG-A view abroad].
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