Abstract
A high-quality advanced training is a key factor for good and safe patient treatment. Germany is currently revising the advanced training curricula and logbooks aiming to change the training into acompetence-based training. The aim of this study was to analyze the day to day reality of orthopedic and trauma surgery advanced training in Germany based on the elements of the advanced training. In March 2020 an online survey on advanced training was carried out with 44 questions on the topics of advanced training curriculum, logbook, educational resources, evaluation, authorized trainer and distribution of working time . A total of 237 persons completed the survey, of which 208 fulfilled the inclusion criteria. The respondents perceived a lack of clear standards in the advanced training curriculum and 25% did not receive structured learning resources in the form of simulations or courses. Mandatory annual process interviews were performed in only 58%. Most respondents valued the expertise of the trainers in orthopedic and trauma surgery, whereas they rated their competence in supervision and giving feedback as below average. Administrative work consumed 220 min of the daily working time and on average 60min remained per day for respondents to learn operative skills. The survey revealed inconsistencies in the current advanced training curriculum and alack of supervision and evaluation. The implementation of competence-based advanced training should therefore not only focus on achange of the curriculum but also on implementing competence-based training at all levels of training (learning resources, training, evaluation).
Highlights
Were duplicate entries avoided by preventing users access to the survey twice; or were duplicate database entries having the same user ID eliminated before analysis? In the latter case, which entries were kept for analysis?
Were duplicate entries avoided by preventing users with the same IP address access to the survey twice or were duplicate database entries having the same IP address within a given period of time eliminated before analysis? If the latter, which entries were kept for analysis?
Was the survey never displayed a second time once the user had filled it in, or was the username stored together with the survey results and later eliminated? If the latter, which entries were kept for analysis?
Summary
Hintergrund und Fragestellung: Eine hochwertige Weiterbildung ist ein Schlüsselfaktor für gute und sichere Patienten- und Patientinnenversorgung. In Deutschland werden derzeit Weiterbildungsordnungen und Logbücher mit dem Ziel überarbeitet, die Weiterbildung in eine kompetenzbasierte Weiterbildung zu überführen. Methoden: Im März 2020 wurde eine Onlinebefragung von Weiterzubildenden mit 44 Fragen zu den Themen Weiterbildungsordnung, Logbuch, Bildungsressourcen, Evaluation, Weiterbildungsbefugte und Arbeitszeitverteilung durchgeführt. Die Weiterzubildenden empfinden einen Mangel an klaren Standards in der Weiterbildungsordnung. Die meisten Weiterzubildenden schätzen die Expertise ihrer Weiterbildenden in der Orthopädie/Unfallchirurgie, während sie deren Kompetenz in Supervision und Feedbackgeben als unterdurchschnittlich bewerten. Diskussion: Die Studie deckt Inkonsistenzen mit der aktuellen Weiterbildungsordnung und ein Defizit an Supervision und Evaluation auf. Besonders in der Chirurgie hängt die Qualität von den Personen ab, die sie durchführen, und deren Fähigkeiten [3, 7, 11, 16, 18]. Um auch in Zukunft einen hohen Standard in der Gesundheitsversorgung zu gewährleisten, ist es unerlässlich, die Weiterbildung anzupassen und zu verbessern. Nur so kann gewährleistet werden, dass die Inhalte der Weiterbildung an aktuelle wissenschaftliche Erkenntnisse, die Erwartung von Patientinnen und Patienten und technische Fortschritte angepasst werden [20]
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