4.2 Article

TrustEd: A Tool for Developing Intraoperative Entrustment Skills

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JOURNAL OF SURGICAL EDUCATION
卷 79, 期 3, 页码 574-578

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.jsurg.2021.12.007

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education; surgery; entrustment; intrao-perative teaching; motivation; graduated autonomy; pro-motion; prevention

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The objective of the study was to develop a supplementary tool to aid faculty and residents in improving entrustment behavior based on different motivational styles. This was achieved by providing dialogue and self-reflection items in the operating room.
OBJECTIVE: Toolkits to assess progressive resident autonomy are integral to the movement toward competency-based surgical education. OpTrust is one such tool validated for intraoperative assessment of both faculty and resident entrustment behaviors. We developed a supplementary tool to OpTrust that would aid faculty and residents in making meaningful improvements in entrustment behavior by providing talking points and reflection items tailored to different motivational styles as defined by Regulatory Focus Theory (RFT).& nbsp;DESIGN: Existing literature about surgical entrustment was used to build a list of sample dialogue and self -reflection items to use in the operating room. This list was distributed as a survey to individuals familiar with OpTrust and RFT, asking them to categorize each item as Promotion-oriented, Prevention-oriented, or Either. The respondents then met to discuss survey items that did not reach a consensus until the group agreed on their categorization.& nbsp;SETTING: University of Wisconsin, School of Medicine and Public Health, Madison, Wisconsin Michigan Medicine, Ann Arbor, Michigan & nbsp;PARTICIPANTS: Clinician and education researchers familiar with intraoperative entrustment and RFT & nbsp;RESULTS: Eight respondents completed the survey categorizing the talking points and reflection items by RFT (100% response rate). Six of these respondents attended the additional meeting to discuss discordant items. The input from this panel was used to develop TrustEd, the supplementary tool that faculty and residents can quickly reference before beginning a case.& nbsp;CONCLUSION: Although tools such as OpTrust allow intraoperative entrustment behaviors to be quantified, TrustEd offers concrete strategies for faculty and residents who are interested in improving those behaviors over time. Further study is needed to assess whether the use of TrustEd does in fact lead to durable behavior change and improvement in OpTrust scores. (C)& nbsp;2021 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

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