Knoll Thomas, Trojan Lutz, Haecker Axel, Alken Peter, Michel Maurice Stephan
Department of Urology, University Hospital Mannheim, Germany.
BJU Int. 2005 Jun;95(9):1276-9. doi: 10.1111/j.1464-410X.2005.05518.x.
To evaluate the outcome of training both urological novices and experts, using the recently developed UroMentor (Simbionix Ltd, Israel) trainer, that provides a realistic simulation of rigid and flexible ureterorenoscopy (URS).
Twenty experienced urologists (total number of previous flexible URSs 21-153) were monitored during simulated flexible URS for treating a lower calyceal stone, and the outcome was correlated with individual experience. A score was compiled based on the variables recorded, including total operation time, stone contact time, complications such as bleeding or perforation, and treatment success. A further five urological residents with no endourological experience were trained on the UroMentor in rigid URS for ureteric stone treatment. Their acquired clinical skills were subsequently compared to those of five urological residents who received no simulator training.
All 20 experienced urologists disintegrated the stone on the simulator, and the score achieved was related to their personal experience; there was a significant difference in performance in those with < 40 and > 80 previous flexible URSs. For the five urological residents with no endourological experience, simulator training improved their skills, and comparison with urological residents who had received no simulator training showed advantages for the trained residents. After being trained on the simulator, the group performed better in the first four URSs on patients.
Individual experience correlates with individual performance on the simulator. Simulator training was helpful in improving clinical skills. Although the distribution of computer-based simulators is limited by high prices, virtual reality-based training has the potential to become an important tool for clinical education.
使用最近开发的UroMentor(以色列Simbionix有限公司)模拟器评估泌尿外科新手和专家的培训效果,该模拟器可逼真模拟硬性和软性输尿管肾镜检查(URS)。
在模拟软性URS治疗下盏结石过程中,对20名经验丰富的泌尿外科医生(既往软性URS操作总数为21 - 153次)进行监测,并将结果与个人经验相关联。根据记录的变量编制评分,包括总手术时间、结石接触时间、出血或穿孔等并发症以及治疗成功率。另外,对5名无腔内泌尿外科经验的泌尿外科住院医师进行UroMentor硬性URS治疗输尿管结石的培训。随后将他们获得的临床技能与5名未接受模拟器培训的泌尿外科住院医师的技能进行比较。
所有20名经验丰富的泌尿外科医生均在模拟器上成功粉碎结石,获得的评分与他们的个人经验相关;既往软性URS操作次数<40次和>80次的医生在操作表现上存在显著差异。对于5名无腔内泌尿外科经验的泌尿外科住院医师,模拟器培训提高了他们的技能,与未接受模拟器培训的泌尿外科住院医师相比,接受培训的住院医师具有优势。在模拟器上接受培训后,该组在对患者进行的前4次URS操作中表现更佳。
个人经验与在模拟器上的个人表现相关。模拟器培训有助于提高临床技能。尽管基于计算机的模拟器因价格高昂而分布受限,但基于虚拟现实的培训有潜力成为临床教育的重要工具。