Effectiveness of setting numerical targets in the surgical training of residents: a trial to achieve an optimal balance.
During the past 10 years, residency training in otorhinolaryngology-head and neck surgery (ORL-HNS) in Japan, especially at university hospitals, has emphasized subspecialization, resulting in insufficiencies in basic surgical techniques with an extreme bias toward acquiring subspecialty surgical case experience. To address this problem, we developed a target-oriented program intended to achieve a more balanced approach to surgical training and performed a 1-year trial of the program at the Jikei University School of Medicine. Fourteen residents with 1 to 4 years of ORL-HNS experience completed the trial. Each resident's competencies in six basic surgical procedures were assessed on the basis of the number of cases handled by the resident, and each resident's case selection bias after implementation of the target-oriented training was examined. The case selection bias in the trial group residents was reduced and their balance in case experience was shown to be improved in comparison with that in control group residents who were trained in the conventional way. In addition, opinion surveys of the participants and supervising otorhinolaryngologists (trainers) indicated that they felt that the new training system had been effective in improving the balance in case experience and improving motivation, and creating greater awareness of training goals and progress.
Section of Research Development, Department of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University.
Kiyoshi
K
Komiya
Momoko
M
Saito
Yuika
Y
Sakurai
Hiromi
H
Kojima
Kozo
K
Takase
D000233:Adenoidectomy / Q000706:statistics & numerical data; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D006040:Goals; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency; D007564:Japan; D008876:Middle Ear Ventilation / Q000706:statistics & numerical data; D009042:Motivation; D009300:Nasal Septum / Q000601:surgery; D059747:Nasal Surgical Procedures / Q000706:statistics & numerical data; D010036:Otolaryngology / Q000193:education*; D013517:Otorhinolaryngologic Surgical Procedures / Q000706:statistics & numerical data*; D016730:Program Development; D015397:Program Evaluation; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data; D014068:Tonsillectomy / Q000706:statistics & numerical data; D014139:Tracheostomy / Q000706:statistics & numerical data; D014420:Turbinates / Q000601:surgery