Shalhav Arieh L, Dabagia Mark D, Wagner Theodore T, Koch Michael O, Lingeman James E
Department of Urology, Indiana University School of Medicine and Methodist Hospital, Indianapolis, USA.
J Urol. 2002 May;167(5):2135-7.
We established a new mini-fellowship training model for teaching laparoscopic urological surgery to practicing urologists that provides a learning experience beyond that of a pelvic trainer or hands-on, animal laboratory based laparoscopic course. It provides the practitioner with clinical experience under mentor direct guidance and supervision before embarking on independent laparoscopic surgery at an individual hospital.
A mini-fellowship model was developed that consists of 3 phases, namely 1) completing a 2 to 3-day hands-on course in laparoscopy, including pelvic trainers and an animal model, 2) observing a clinical mentor perform 6 or more major renal laparoscopic cases and 3) performing 6 or more major renal procedures under mentor direct guidance in trainee patients at the mentor or trainee hospital after obtaining appropriate temporary privileges.
Two community urologists underwent the mini-fellowship program in 2000. Trainee 1 performed 30 laparoscopic procedures, including 17 radical nephrectomies, 4 simple nephrectomies, 4 nephroureterectomies, 4 renal cyst ablations and 1 renal biopsy, within the first 8 months after training and hospital accreditation. Trainee 2 performed 10 laparoscopic procedures within the first 3 months after training and hospital accreditation.
This mini-fellowship model provides practicing urologists with a clinically applicable teaching experience to learn a new surgical concept using a familiar training pattern. It may be a more rapid and safe process of disseminating laparoscopic urological surgery to community urologists. Based on this model it would be possible for centers of excellence in each state to establish similar training programs for the corresponding urological community, thereby, bringing the teaching of new surgical skills to a more clinically relevant level.
我们为执业泌尿科医生建立了一种新的小型进修培训模式，用于教授腹腔镜泌尿外科手术，该模式提供的学习体验超越了盆腔训练器或基于动物实验室的实践腹腔镜课程。它使从业者在个体医院开始独立腹腔镜手术之前，能在导师的直接指导和监督下获得临床经验。
开发了一种小型进修模式，包括三个阶段，即1）完成为期2至3天的腹腔镜实践课程，包括盆腔训练器和动物模型；2）观摩临床导师进行6台或更多台主要的肾脏腹腔镜手术；3）在获得适当的临时权限后，在导师或实习医生所在医院，在导师的直接指导下为实习患者进行6台或更多台主要的肾脏手术。
2000年，两名社区泌尿科医生参加了小型进修项目。学员1在培训和医院认证后的前8个月内进行了30例腹腔镜手术，包括17例根治性肾切除术、4例单纯肾切除术、4例肾输尿管切除术、4例肾囊肿消融术和1例肾活检。学员2在培训和医院认证后的前3个月内进行了10例腹腔镜手术。
这种小型进修模式为执业泌尿科医生提供了一种临床适用的教学体验，使其能够使用熟悉的培训模式学习新的手术概念。这可能是将腹腔镜泌尿外科手术传播给社区泌尿科医生的一个更快、更安全的过程。基于此模式，每个州的卓越中心有可能为相应的泌尿外科社区建立类似的培训项目，从而将新手术技能的教学提升到更具临床相关性的水平。
