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Xu X, Ruan X, Yu C, Yu X, Quan X, Li X, Yuan T, Xia D, Zhang Y, Pei L. Differences between resident self-assessments and faculty- assessments on Anesthesiology Milestones and associated factors: a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:551. [PMID: 38760807 PMCID: PMC11100080 DOI: 10.1186/s12909-024-05544-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Accurate self-assessment is crucial for the professional development of physicians. There has been sparse data on the accuracy of self-assessments on Anesthesiology Milestones. The aim of this study was to investigate the differences between resident self-assessments and faculty-assessments on Anesthesiology Milestones and the associated factors. METHODS This was a cross-sectional study conducted in a general tertiary university-affiliated hospital. We included anesthesia residents who were enrolled in the standardized residency training program in postgraduate year two and three at the time of the Milestone evaluation. We requested evaluations of competencies from both the Clinical Competency Committee faculty and the anesthesia residents themselves, utilizing the Chinese version of Anesthesiology Milestones in January 2023 and January 2024. The primary outcome was the differences between self- and faculty-assessments, calculated by subtracting the faculty-rated score from the self-rated score on each subcompetency. RESULTS A total of 46 and 42 residents were evaluated in year 2023 and 2024, respectively. The self-rated sum score was significantly higher than that rated by faculty [mean (standardized deviation): 120.39 (32.41) vs. 114.44 (23.71), P = 0.008 in paired t test] with an intraclass correlation coefficient of 0.55 [95% confidence interval (CI): 0.31 to 0.70]. The Bland-Altman plots revealed significant overestimation in patient care (bias 0.32, 95% CI: 0.05 to 0.60), practice-based learning and improvement (bias 0.45, 95% CI: 0.07 to 0.84), and professionalism (bias 0.37, 95% CI: 0.02 to 0.72). Ratings from residents with master's degrees (mean difference: -1.06, 95% CI: -1.80 to -0.32, P = 0.005) and doctorate degrees (mean difference: -1.14, 95% CI: -1.91 to -0.38, P = 0.003) were closer to the faculty-assessments than residents with bachelor's degrees. Compared with patient care, the differences between self- and faculty- rated scores were smaller in medical knowledge (mean difference: -0.18, 95% CI: -0.35 to -0.02, P = 0.031) and interpersonal and communication skills (mean difference: -0.41, 95% CI: -0.64 to -0.19, P < 0.001) in the generalized estimating equation logistic regression model. CONCLUSIONS This study revealed that residents tended to overestimate themselves, emphasizing the need to improve the accuracy of Milestones self-assessment. The differences between self- and faculty-assessments were associated with residents' degrees and domains of competency.
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Affiliation(s)
- Xiaohan Xu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China
| | - Xia Ruan
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China.
| | - Chunhua Yu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China
| | - Xuerong Yu
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China
| | - Xiang Quan
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China
| | - Xu Li
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China
| | - Tangmi Yuan
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China
| | - Di Xia
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China
| | - Yuelun Zhang
- Centre for Prevention and Early Intervention, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China
| | - Lijian Pei
- Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, 100730, China
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Zhu Y, Wang Z, Zhong Y, Duan X, Qu B. The mediating role of work-related perceptions in the relationship between empathy and self-perceived clinical performance of residents in China: A multi-center cross-sectional study. PATIENT EDUCATION AND COUNSELING 2024; 119:108089. [PMID: 38008646 DOI: 10.1016/j.pec.2023.108089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 11/07/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023]
Abstract
OBJECTIVE This study aimed to describe the association between empathy and residents' clinical performance and investigate whether work-related perception mediates this relationship. METHODS A multi-center cross-sectional study was conducted, including 1160 residents from 10 cities in Liaoning Province between March and October 2020. The participants completed various self-reported questionnaires regarding demographic characteristics, work-related perceptions, self-perceived clinical performance, and empathy. The relationships among empathy, work-related perception, and self-perceived clinical performance were examined using a structural equation model (SEM). RESULTS Of the 1160 residents, 961 (82.8 %) completed the questionnaires. The SEM path analysis showed that the direct effect of empathy on self-perceived clinical performance was significant and positive (β = 0.34, P < 0.001). There existed significant effects of empathy on work-related perception (β = 0.26, P < 0.001) and work-related perception on performance (β = 0.31, P < 0.001). The path coefficients of empathy concerning self-perceived clinical performance decreased significantly (β = 0.26, P < 0.001) when work-related perception was modeled as a mediator. The bias-corrected and accelerated bootstrap test revealed that work-related perception significantly mediated the relationship between empathy and self-perceived clinical performance (a*b = 0.08, BCa 95 % CI: 0.05-0.13). However, the correlation between the sub-scales of empathy and the items of self-perceived clinical performance was not substantial, even if most of them were statistically significant. The final SEM produced a good fit to the sample data, with CMIN/DF = 2.07 (P < 0.001), CFI = 0.99, GFI = 0.99, AGFI = 0.98, TLI = 0.98, NFI = 0.97, RMSEA (90 % CI) = 0.033 (0.017, 0.049), and SRMR = 0.024. CONCLUSION Empathy might significantly affect self-perceived clinical performance both directly and indirectly through the mediating role of work-related perception. PRACTICE IMPLICATIONS Efforts to improve clinical performance among residents might benefit from interventions for cultivating empathy and practices for improving work-related perceptions of residents.
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Affiliation(s)
- Yaxin Zhu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang 110122, PR China
| | - Ziqi Wang
- Institute for International Health Professions Education and Research, China Medical University, Shenyang 110122, PR China
| | - Yifan Zhong
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang 110000, PR China
| | - Xiyu Duan
- Institute for International Health Professions Education and Research, China Medical University, Shenyang 110122, PR China
| | - Bo Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang 110122, PR China.
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Okata Y, Murakami M, Uemura M, Tsuruno Y, Iwabuchi S, Kameoka Y, Yoshimura S, Takanarita Y, Watanabe A, Uemura K, Miyauchi H, Nakatani T, Tomioka Y, Samejima Y, Hatakeyama T, Ieiri S, Bitoh Y. Endosurgery workshop to improve the confidence of novice pediatric surgeons in performing laparoscopic hepaticojejunostomy. Pediatr Surg Int 2024; 40:45. [PMID: 38294567 DOI: 10.1007/s00383-024-05631-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/02/2024] [Indexed: 02/01/2024]
Abstract
PURPOSE This study assessed the efficacy of a high-impact, short-term workshop in honing the laparoscopic hepaticojejunostomy technical skills and self-confidence of novice pediatric surgeons, focusing on vertical needle driving and knot tying. METHODS Lectures, hands-on sessions, pre- and post-workshop evaluations, and training using porcine models were conducted to refine basic and advanced skills. The "hepaticojejunostomy simulator" was used for comparative analysis of precision in pre- and post-workshop vertical needle driving and knot tying. Participants self-evaluated their skills and confidence on a 5-point scale. RESULTS After the workshop, eight inexperienced pediatric surgeons demonstrated a significant improvement in hepaticojejunostomy suturing task completion rates and needle-driving precision at the jejunum and hepatic duct. However, the A-Lap Mini Endoscopic Surgery Skill Assessment System indicated no significant improvements in most assessed parameters, except for the full-layer closure score (p = 0.03). However, a significant increase in participants' confidence levels in performing laparoscopic hepaticojejunostomy was observed. CONCLUSION The workshop augmented technical proficiency and confidence in young pediatric surgeons. The combination of lectures, practical exposure, and model training is an effective educational strategy in pediatric surgical instruction.
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Affiliation(s)
- Yuichi Okata
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masakazu Murakami
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan
| | - Munenori Uemura
- Kobe University Center for Advanced Medical Engineering Research and Development Therapeutic Medical Device Development Division, Kobe, Japan
| | - Yudai Tsuruno
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Serena Iwabuchi
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuyuki Kameoka
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shohei Yoshimura
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuki Takanarita
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Aya Watanabe
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kotaro Uemura
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Harunori Miyauchi
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Taichi Nakatani
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
- Department of Pediatric Surgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Yuichiro Tomioka
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshitomo Samejima
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tadashi Hatakeyama
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
- Department of Pediatric Surgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Satoshi Ieiri
- Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan.
| | - Yuko Bitoh
- Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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