Qayumi A K, Cheifetz R E, Forward A D, Baird R M, Litherland H K, Koetting S E
Department of Surgery, University of British Columbia, Vancouver, Canada.
J Invest Surg. 1999 Nov-Dec;12(6):341-50.
Surgical technical education has traditionally followed an apprenticeship format. The need for innovative undergraduate programs using dry and wet labs prior to clinical exposure continues to be an area of debate. Specific programs have been described to improve surgical skills; however, an accepted platform for training and evaluation of surgical skills programs has not been recognized. Therefore, introduction of specific programs to teach undergraduate medical students surgical skills is essential. This article describes the Basic Surgical Technique (BST) program taught at the University of British Columbia and reports the effectiveness of this program in improving the practical skills of undergraduate medical students. The program includes BST I for third-year students performed in a dry lab setting, and BST II for medical student interns (MSI) performed at the animal laboratories using female domestic swine as subjects. A total of 87 students participated in the study. The program is designed using Piaget's and Vygotsky's pedagogical philosophy of "learning by doing." A semiquantitative method is used to measure and analyze the outcome of this project. Data were validated using student self-evaluation tests and by quantitative evaluation by surgical staff from the surgical wards. Results of this prospective project indicated that the BST program significantly (p < .05) improved the surgical performance of undergraduate students, and that the time lapse between BST I and II has had a negative impact in retention of acquired surgical skills. This study concludes that the BST program taught at the University of British Columbia significantly improves the surgical skills of medical students and improves their self-confidence during their internship.
传统上,外科技术教育一直采用学徒制形式。在临床实习之前,是否需要通过使用模拟实验室和实体实验室的创新本科课程,仍是一个存在争议的领域。已经有一些特定的课程被描述用于提高外科技能;然而,尚未有一个被认可的培训和评估外科技能课程的平台。因此,引入特定课程来教授本科医学生外科技能至关重要。本文介绍了英属哥伦比亚大学所教授的基础外科技术(BST)课程,并报告了该课程在提高本科医学生实践技能方面的有效性。该课程包括面向三年级学生在模拟实验室环境中进行的BST I,以及面向医学实习生(MSI)在动物实验室以雌性家猪为实验对象进行的BST II。共有87名学生参与了该研究。该课程是根据皮亚杰和维果茨基的“通过实践学习”的教学理念设计的。采用半定量方法来测量和分析该项目的结果。数据通过学生自我评估测试以及外科病房外科工作人员的定量评估进行验证。这个前瞻性项目的结果表明,BST课程显著(p < 0.05)提高了本科生的手术操作水平,并且BST I和BST II之间的时间间隔对已掌握的外科技能的保持产生了负面影响。本研究得出结论,英属哥伦比亚大学教授的BST课程显著提高了医学生的外科技能,并增强了他们在实习期间的自信心。