Adrales G L, Chu U B, Hoskins J D, Witzke D B, Park A E
Department of Surgery, Minimally Invasive Center, University of Kentucky College of Medicine, Lexington, KY, USA.
Am J Surg. 2004 Feb;187(2):157-63. doi: 10.1016/j.amjsurg.2003.11.020.
Practical programs for training and evaluating surgeons in laparoscopy are needed to keep pace with demand for minimally invasive surgery.
At the University of Kentucky five inexpensive simulations have been developed to train and assess surgical residents. Residents are videotaped performing laparoscopic procedures on models. Five surgeons assess the taped performances on 4 global skills.
Creating mechanical models reduces training costs. Trainees agreed procedures were well represented by the simulations. Blinded assessment of performances showed high interrater agreement and correlated with the trainees' level of experience. Nonclinician evaluations on checklists correlated with evaluations by surgeons.
Inexpensive simulations of laparoscopic appendectomy, cholecystectomy, inguinal herniorrhaphy, bowel enterotomy, and splenectomy enable surgical residents to practice laparoscopic skills safely. Obtaining masked, objective, and independent evaluations of basic skills in laparoscopic surgery can assist in reliable assessment of surgical trainees. The simulations described can anchor an innovative educational program during residency for training and assessment.
为跟上微创手术的需求，需要有实用的腹腔镜手术培训和评估外科医生的项目。
肯塔基大学开发了五种低成本模拟方法来培训和评估外科住院医师。住院医师在模型上进行腹腔镜手术时会被录像。五位外科医生根据四项整体技能对录像表现进行评估。
制作机械模型可降低培训成本。实习生认为模拟很好地再现了手术过程。对表现进行盲法评估显示评估者间高度一致，且与实习生的经验水平相关。非临床医生根据检查表进行的评估与外科医生的评估相关。
腹腔镜阑尾切除术、胆囊切除术、腹股沟疝修补术、肠切开术和脾切除术的低成本模拟，能让外科住院医师安全地练习腹腔镜技能。对腹腔镜手术基本技能进行隐蔽、客观和独立的评估有助于可靠地评估外科实习生。所描述的模拟可作为住院医师培训和评估创新教育项目的基础。
