Bann Simon, Khan Mansoor S, Datta Vivek K, Darzi Ara W
Department of Surgical Oncology and Technology, Imperial College of Science, Technology and Medicine, 10th Floor QEQM Wing, St. Mary's Hospital, W2 1NY London, UK.
World J Surg. 2004 Feb;28(2):142-6; discussion 146-7. doi: 10.1007/s00268-003-7071-z. Epub 2004 Jan 8.
Technical performance consists of surgical knowledge, judgment, and dexterity. Although assessment of surgical dexterity is now possible, assessing technical knowledge and its relation to dexterity has not been elucidated. Surgeons of varying experience were recruited to the skills laboratory to undertake three assessments: simple surgical dexterity (at 14 stations scored by motion analysis), an operating room equipment examination, and a novel error analysis. The scores were correlated, and p < 0.05 was deemed to be significant. Thirty surgeons were recruited; and construct validity was exhibited in all areas. Correlations were shown to exist between the two knowledge examinations (Spearman's rho = 0.39). Correlations existed between all dexterity task parameters and the equipment examination, whereas they existed for only 15 of the 28 parameters of the error examination and were always weaker. The stronger correlations between dexterity and instrument and operating room (OR) equipment reflect greater surgical experience and time spent in the OR. The weaker correlations between the error analysis and dexterity suggest that these skills are learned at different times. The identification of common surgical errors should be more formally taught to ensure greater uniformity.
技术表现包括手术知识、判断力和灵活性。虽然现在可以对外科手术的灵活性进行评估，但技术知识及其与灵活性的关系尚未阐明。招募了不同经验的外科医生到技能实验室进行三项评估：简单手术灵活性（在14个站点通过运动分析评分）、手术室设备检查和一项新颖的错误分析。对分数进行了相关性分析，p < 0.05被认为具有显著性。招募了30名外科医生；所有领域均显示出结构效度。两项知识考试之间存在相关性（斯皮尔曼等级相关系数 = 0.39）。所有灵活性任务参数与设备检查之间都存在相关性，而在错误分析的28个参数中，只有15个存在相关性，且相关性总是较弱。灵活性与器械和手术室（OR）设备之间更强的相关性反映了更丰富的手术经验和在手术室花费的时间。错误分析与灵活性之间较弱的相关性表明这些技能是在不同时间学到的。应更正式地教授常见手术错误的识别方法，以确保更大的一致性。
