Brehmer Marianne, Swartz Robert
Department of Urology, Karolinska University Hospital, Stockholm, Sweden.
Eur Urol. 2005 Sep;48(3):458-63; discussion 463. doi: 10.1016/j.eururo.2005.04.031.
There is a need for alternative training in endourology. Computerised simulators have been introduced but have, so far, not been compared to real surgery. Bench models have proved to be comparable to real surgery when performing standard procedures in the upper urinary tract.
To validate training on bench models as a tool to improve dexterity in semi-rigid ureteroscopy.
Urology residents were tested when performing semi-rigid ureteroscopy on a bench model (Mediskills), before and after training. All standard equipment and instruments, including fluoroscopy, were available. For the test procedure we used a task-specific checklist and a global score (maximum score 10 + 9 = 19). After base line assessment, the participants practised under supervision. After training they were reassessed, using the same procedure as previously.
The performance was significantly better after the training. Results before/after were: 5.1/9.2, 2.6/7.8 and 7.7/17.2 for task-specific checklist, global score and total score respectively. All residents felt more familiar with the instruments and the procedure after the training.
Training on bench models for ureteroscopy enhanced the manual dexterity as well as familiarity with the method and is recommendable before operating on patients.
腔内泌尿外科需要替代性培训方法。计算机模拟器已被引入，但到目前为止，尚未与实际手术进行比较。在进行上尿路标准手术时，实体模型已被证明与实际手术相当。
验证实体模型培训作为提高半硬性输尿管镜操作灵活性的一种工具。
泌尿外科住院医师在实体模型（Mediskills）上进行半硬性输尿管镜操作培训前后接受测试。所有标准设备和器械，包括荧光镜检查设备均可用。对于测试过程，我们使用了特定任务清单和整体评分（最高评分10 + 9 = 19）。在基线评估后，参与者在监督下进行练习。培训后，使用与之前相同的程序对他们进行重新评估。
培训后的表现明显更好。特定任务清单、整体评分和总分在培训前后的结果分别为：5.1/9.2、2.6/7.8和7.7/17.2。所有住院医师在培训后对器械和操作过程都感觉更加熟悉。
输尿管镜实体模型培训提高了操作灵活性以及对该方法的熟悉程度，建议在对患者进行手术前进行此类培训。
