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1.
Surgery ; 172(4): 1102-1108, 2022 10.
Article in English | MEDLINE | ID: mdl-35871106

ABSTRACT

BACKGROUND: Communication errors contribute to preventable adverse hospital events; however, communication between general surgery residents and nurses remains insufficiently studied. The purpose of our study was to use qualitative methods to characterize communication practices of surgical residents and nurses on inpatient general and intermediate care units to inform best practices and future interprofessional interventions. METHODS: Our study cohort consisted of 14 general surgery residents and 13 inpatient nurses from a tertiary academic medical center. Focus groups were conducted via a secure video platform, recorded, and transcribed. Two authors performed open coding of transcripts for qualitative analysis. Codes were reviewed iteratively with themes generated via abductive analysis, contextualizing results within 3 domains of an established communication space framework: organizational, cognitive, and social complexity. RESULTS: Communication practices of general surgery residents and inpatient nurses are affected by workflow differences, disruptive communication patterns, and communication technology. Barriers to effective communication, as well as strategies used to mitigate challenges, were characterized, with select communication practices found to negatively affect the well-being of patients, nurses, and residents. CONCLUSION: Communication practices of general surgery residents and inpatient nurses are influenced by entrenched and interrelated organizational, technological, and interpersonal factors. Given that current communication practices negatively affect patient and provider well-being, collaboration between surgeons, nurses, systems engineers, health information technology experts, and other stakeholders is critical to (1) establish communication best practices, and (2) design interventions to assess and improve multiple areas (rather than isolated domains) of surgical interprofessional communication.


Subject(s)
Communication , General Surgery , Academic Medical Centers , Focus Groups , Humans , Inpatients , Qualitative Research
2.
J Surg Educ ; 79(3): 569-573, 2022.
Article in English | MEDLINE | ID: mdl-34952816

ABSTRACT

OBJECTIVE: Metacognition plays an important role in the professional development and growth of surgical educators. This work presents the development and pilot of the MAISE (Metacognitive Awareness Inventory for Surgical Educators). The MAISE is a novel tool for surgeons who are teaching residents in workplace-based learning environments and provides a framework for surgeons to consider their roles as educators and prompt reflection on potential areas for self-improvement. DESIGN: The MAISE was developed for the surgical context by a general surgery resident by revising 2 existing validated instruments designed to measure metacognitive processes related to teaching. The first version of the MAISE consisted of 35 statements designed to measure 7 subdimensions of metacognition (factors). A principal components analysis with a varimax rotation was conducted, and factor loadings greater than 0.4 were used to assign items to factors. SETTING: The initial version of the MAISE was piloted by recruiting participants via email and social media platforms (Facebook and Twitter). PARTICIPANTS: Thirty participants who identified as attending surgeons with resident teaching responsibilities completed the initial version of the MAISE. RESULTS: Twenty-four of the 35 original items were included in the final version of the MAISE, which includes 5 factors. Final factors were determined based on item loadings. When items loaded on more than one factor, interpretability was used to decide which factor to which an item was assigned. Some factors were excluded due to lack of interpretability. This model explained 85% of the variance in the data. CONCLUSIONS: MAISE is a valid tool for assessing metacognition among surgical educators. Improving surgeons' metacognition of their teaching practices may advance the surgical field by promoting reflection on teaching processes and areas for growth. This will help surgical educators develop their teaching practices and to employ and model effective teaching with trainees.


Subject(s)
Metacognition , Humans
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