Pace Kenneth T, Ghiculete Daniela, Harju Melanie, Honey R John
Division of Urology, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Can J Urol. 2006 Jun;13(3):3147-52.
The optimal method of acquiring laparoscopic skills has not been determined. We sought to examine the current status of urologic laparoscopy and how practicing urologists acquired the skills needed to perform laparoscopic procedures.
A mail questionnaire regarding laparoscopic practices and training was sent to 480 members of the Canadian Urological Association (CUA) using standard Dillman survey methodology.
Three hundred (62.5%) urologists responded to the questionnaire; 56.5% practiced in the community and 41.1% in an academic setting. There were 59.9% who had completed some form of fellowship training. Recent graduates (who finished residency after 1995) were more likely to perform all types of laparoscopic procedures compared to older graduates (65% versus 29.7%, p < 0.001). Advanced procedures were also performed more frequently by recent graduates (52.5% versus 23.4%, p < 0.001). Of those who do not currently perform laparoscopy, 38.2% plan to learn in the future. The most common method of acquiring laparoscopic skills was with animal laboratory experience (39.4%), but only 20.9% relied solely on this method. A trip to a centre of excellence (28.5%) and training from an urologist at the same institution (25.7 %) was also commonly reported as methods of acquiring skills. There were 48.8% who reported beginning laparoscopic procedures without a mentor.
A substantial portion of the Canadian urological community employs laparoscopy, although recent graduates are more likely to do so. Training methods in laparoscopy are variable, but a substantial portion of urologists begin practicing laparoscopic procedures without formal mentoring.
获取腹腔镜手术技能的最佳方法尚未确定。我们试图研究泌尿外科腹腔镜手术的现状以及泌尿外科医生如何获得进行腹腔镜手术所需的技能。
采用标准的迪尔曼调查方法,向加拿大泌尿外科协会(CUA)的480名成员发送了一份关于腹腔镜手术实践和培训的邮寄问卷。
300名(62.5%)泌尿外科医生回复了问卷;56.5%在社区执业,41.1%在学术机构执业。59.9%的人完成了某种形式的专科培训。与年长的毕业生相比,近期毕业生(1995年后完成住院医师培训)更有可能进行所有类型的腹腔镜手术(65%对29.7%,p<0.001)。近期毕业生进行高级手术的频率也更高(52.5%对23.4%,p<0.001)。在目前不进行腹腔镜手术的人中,38.2%计划在未来学习。获取腹腔镜手术技能最常见的方法是动物实验室经验(39.4%),但只有20.9%的人仅依赖这种方法。前往卓越中心学习(28.5%)以及在同一机构接受泌尿外科医生的培训(25.7%)也常被报告为获取技能的方法。有48.8%的人报告在没有导师的情况下开始进行腹腔镜手术。
加拿大泌尿外科界有很大一部分人采用腹腔镜手术,尽管近期毕业生更有可能这样做。腹腔镜手术的培训方法各不相同,但很大一部分泌尿外科医生在没有正式指导的情况下开始进行腹腔镜手术。