Operative Ausbildungsziele in der Plastischen und Ästhetischen Chirurgie einfach „SMART“

Zusammenfassung

Einleitung Der Prozess des lebenslangen Kompetenzerwerbs in medizinischen Berufen spielt im Rahmen der Neustrukturierung der Studiengänge eine besondere Rolle. Das aktive, selbstbestimmte Lernen findet Anwendung auch in der operativen Ausbildung, um manuelle Fertigkeiten zu erlernen. Die individualisierte, spezifisch auf die Bedürfnisse des Lernenden abgestimmte Zielsetzung gefolgt von Übungen sowie Feedback ermöglicht den Erwerb operativer Kompetenz.

Material und Methoden Die chirurgische Ausbildung ähnelt einer musischen Ausbildung oder Sportausübung, da sowohl intellektuelle als auch manuelle Fertigkeiten erworben werden müssen. Dort kommen Trainingsprinzipien bestehend aus Fehleranalyse, Zielsetzung, Übung sowie Reflexion erfolgreich zum Einsatz. Die Zielsetzung wird entsprechend dem SMART Prinzip gewählt, um eine bestmögliche Umsetzung zu gewährleisten. Diese Übungsstrategie kann auch in der operativen Ausbildung zum Einsatz kommen.

Anwendungen Dem Ausbildungsstadium entsprechend, können sowohl chirurgische Prinzipien als auch Teilaspekte bis komplette Eingriffe dem SMART Prinzip entsprechend geübt werden. Dies ermöglicht den Kompetenzerwerb und das Erlernen manueller Fertigkeiten ohne Nachteile für die Patientensicherheit.

Diskussion Die chirurgische Ausbildung beinhaltet den Erwerb von intellektuellen als auch manuellen Fertigkeiten und ist demnach mit anderen kompetitiven Felder wie Musik und Sport vergleichbar. Im Gegensatz dazu sind allerdings die Trainingsmöglichkeiten im heutigen Spannungsfeld zwischen Hochleistungsmedizin und Kostendruck für den Erwerb chirurgischer Fähigkeiten limitiert. Daher sind Simulationsmöglichkeiten im Rahmen des selbstbestimmten Lernens von zunehmender Bedeutung. Das SMART Prinzip in der Zielsetzung ermöglicht die Fragmentierung von komplexen operativen Schritten in Teilbereiche, welche in einem überschaubaren Zeitrahmen erfolgreich erlernt werden können. Da diese Art der Entwicklung nicht allen Individuen intuitiv verfügbar ist, kann dieses Prinzip von Ausbildern und Mentoren empfohlen werden, um auch außerhalb des Operationsaals manuelle Fertigkeiten zu erlernen.

Abstract

Introduction The process of continuous acquisition of surgical expertise is a key element in registrar training. The principle of active, self-directed learning, which is regularly applied in medical school, can also be used to gain surgical expertise in registrar training.

Methods Surgical training can be compared to acquiring expertise in music or sport, where both intellectual and manual capabilities are required. Specific training principles, including analysis, goal setting, practice and reflection on the process, are commonly encountered in these fields. Smart goal setting is preferred in order to ensure compliance and a successful strategy. This can also be used in plastic surgery training.

Application Surgical principles as well as partial or complete surgical procedures can be practiced using the smart principle. The fragmentation of a larger task into smaller units allows rapid acquisition of surgical expertise without impeding patient safety.

Discussion Surgical training today happens in a setting caught between economic and medicolegal challenges. The reduction of case load requires simulation practice as well as self-directed learning – which has been shown to improve outcomes. The smart principle allows distinct goal setting which can improve compliance of the student and increase success. As this form of learning is not intuitive to all individuals, supervisors and mentor can support trainees in the acquisition of surgical expertise using this principle.

Schlüsselwörter

Weiterbildung, Sonstige Aspekte

Key words

Smart Principle - procedural skills teaching - deliberate practice

Publikationsverlauf

Eingereicht: 26. Juni 2023

Angenommen: 08. August 2023

Artikel online veröffentlicht:
02. November 2023

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