Bridges M, Diamond D L
Department of Surgery, University of Tennessee Medical Center-Knoxville, USA.
Am J Surg. 1999 Jan;177(1):28-32. doi: 10.1016/s0002-9610(98)00289-x.
There have been no published data regarding the cost of training surgical residents in the operating room.
At the University of Tennessee Medical Center-Knoxville, in addition to resident-performed teaching cases, some cases are performed without the assistance of residents by the same faculty.
Sixty-two case categories involving 14,452 cases were compared for operative times alone. In 46 case categories (10,787 procedures), resident operative times were longer than faculty alone. In 16 case categories, resident operating times were shorter than faculty times. The net incremental operative time cost was 2,050 hours between July 1993 and March 1997. Assuming 4 years of operative training for 11 graduating chief residents, the cost per graduating resident was $47,970.
Extrapolated to a national annual cost for the 1,014 general surgery residents who completed training in the 1997 academic year, the annual cost of training residents in the operating room is $53 million. This high monetary cost suggests the need for digital skills, selection criteria, the development of training curriculum and resource facilities, the pre-operating room need for suturing and stapling techniques, and perhaps the acquisition of virtual surgery training modules.
关于培训外科住院医师的手术室成本，尚无已发表的数据。
在田纳西大学医学中心诺克斯维尔分校，除了住院医师参与的教学病例外，一些病例由相同的教员在没有住院医师协助的情况下进行。
仅比较了涉及14452例病例的62个病例类别中的手术时间。在46个病例类别（10787例手术）中，住院医师的手术时间比仅由教员进行手术的时间长。在16个病例类别中，住院医师的手术时间比教员的时间短。1993年7月至1997年3月期间，净增加的手术时间成本为2050小时。假设11名即将毕业的住院总医师接受4年的手术培训，每名毕业住院医师的成本为47970美元。
推断1997学年完成培训的1014名普通外科住院医师的全国年度成本，在手术室培训住院医师的年度成本为5300万美元。如此高昂的资金成本表明需要数字技能、选拔标准、培训课程和资源设施的开发、术前对缝合和吻合技术的需求，或许还需要购置虚拟手术培训模块。
