Umfrage zur Weiterbildung Orthopädie/Unfallchirurgie

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. Ziel der Studie ist die Analyse der täglichen Realität der orthopädisch-chirurgischen Weiterbildung in Deutschland anhand der Elemente der Weiterbildung. Im März 2020 wurde eine Onlinebefragung von Weiterzubildenden mit 44 Fragen zu den Themen Weiterbildungsordnung, Logbuch, Bildungsressourcen, Evaluation, Weiterbildungsbefugte und Arbeitszeitverteilung durchgeführt. Insgesamt 237 Personen beantworteten die Umfrage, 208 erfüllten die Einschlusskriterien. Die Weiterzubildenden empfinden einen Mangel an klaren Standards in der Weiterbildungsordnung. 25 % der Weiterzubildenden erhalten keine strukturierten Lernressourcen wie beispielsweise Simulationen oder Kurse. Weiterbildungsgespräche werden in 58 % der Fälle durchgeführt. Die meisten Weiterzubildenden schätzen die Expertise ihrer Weiterbildenden in der Orthopädie/Unfallchirurgie, während sie deren Kompetenz in Supervision und Feedbackgeben als unterdurchschnittlich bewerten. Administratives Arbeiten umfasst 220 min der täglichen Arbeitszeit, im Schnitt verbleiben 60 min pro Tag und Weiterzubildenden, um operative Tätigkeiten zu erlernen. Die Studie deckt Inkonsistenzen mit der aktuellen Weiterbildungsordnung und ein Defizit an Supervision und Evaluation auf. Die Überführung in kompetenzbasierte Weiterbildung sollte daher nicht ausschließlich auf einer Anpassung der Weiterbildungsordnung beruhen, sondern auf allen Ebenen der Weiterbildung anvisiert werden (Lernressourcen Ausbildung der Weiterbildenden, Evaluation).


(methods)
Contact mode Indicate whether or not the initial contact with the potential participants was made on the Internet. (Investigators may also send out questionnaires by mail and allow for Web-based data entry.)

(methods)
Advertising the survey How/where was the survey announced or advertised? Some examples are offline media (newspapers), or online (mailing lists-If yes, which ones?) or banner ads (Where were these banner ads posted and what did they look like?). It is important to know the wording of the announcement as it will heavily influence who chooses to participate. Ideally the survey announcement should be published as an appendix

(methods)
Web/E-mail State the type of e-survey (e.g. one posted on a Web site, or one sent out through e-mail). If it is an e-mail survey, were the responses entered manually into a database, or was there an automatic method for capturing responses? Over how many pages was the questionnaire distributed? The number of items is an important factor for the completion rate

(methods)
Completeness check It is technically possible to do consistency or completeness checks before the questionnaire is submitted. Was this done, and if "yes", how (usually JAVAScript)? An alternative is to check for completeness after the questionnaire has been submitted (and highlight mandatory items). If this has been done, it should be reported. All items should provide a non-response option such as "not applicable" or "rather not say", and selection of one response option should be enforced Count the unique number of people who filled in the first survey page (or agreed to participate, for example by checking a checkbox), divided by visitors who visit the first page of the survey (or the informed consents page, if present). This can also be called "recruitment" rate N/A Completion rate (ratio of users who finished the survey/users who agreed to participate) The number of people submitting the last questionnaire page, divided by the number of people who agreed to participate (or submitted the first survey page). This is only relevant if there is a separate "informed consent" page or if the survey goes over several pages. This is a measure for attrition. Note that "completion" can involve leaving questionnaire items blank. This is not a measure for how completely questionnaires were filled in. (If you need a measure for this, use the word "completeness rate".) -

Cookies used
Indicate whether cookies were used to assign a unique user identifier to each client computer. If so, mention the page on which the cookie was set and read, and how long the cookie was valid. 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 (e.g. the first entry or the most recent)?

(methods)
IP check Indicate whether the IP address of the client computer was used to identify potential duplicate entries from the same user. If so, mention the period of time for which no two entries from the same IP address were allowed (e.g. 24 h). 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 (e.g. the first entry or the most recent)?

(methods)
Log file analysis Indicate whether other techniques to analyze the log file for identification of multiple entries were used. If so, please describe 3 (methods)

Registration
In "closed" (non-open) surveys, users need to login first and it is easier to prevent duplicate entries from the same user. Describe how this was done. For example, 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 (e.g. the first entry or the most recent)?

Handling of incomplete questionnaires
Were only completed questionnaires analyzed? Were questionnaires which terminated early (where, for example, users did not go through all questionnaire pages) also analyzed?

Results
Questionnaires submitted with an atypical time stamp Some investigators may measure the time people needed to fill in a questionnaire and exclude questionnaires that were submitted too soon. Specify the timeframe that was used as a cut-off point, and describe how this point was determined

Literatur
Survey on training in orthopedics/trauma surgery. Is Germany ready for a competence-based training?
Background and objective: 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 a competence-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. Methods: 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 .
Results: 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.

Conclusion:
The survey revealed inconsistencies in the current advanced training curriculum and a lack of supervision and evaluation. The implementation of competence-based advanced training should therefore not only focus on a change of the curriculum but also on implementing competence-based training at all levels of training (learning resources, training, evaluation).

Keywords
Advanced training curriculum · Working time distribution · Logbook · Specialised training · Authorized trainer