Rosenberg Aaron G
Department of Orthopedic Surgery, Rush Medical College, Chicago, Illinois, USA.
Am J Orthop (Belle Mead NJ). 2006 Jul;35(7 Suppl):30-2.
The traditional didactic approach to improving the skill set of surgeons has been shown to have minimal impact. Surgeons, like other adults, learn best by doing, by practicing what they do. and by challenging themselves to take on increasingly difficult scenarios. To be effective, surgical practice requires deconstruction of a procedure into key elements, each of which is repeated until optimal results are achieved before moving on to the next element. Given the multifactorial nature of a procedure such as minimally invasive surgery for total knee arthroplasty, surgeons need to introduce incremental changes into their operating environment to allow for realistic self-assessment during postoperative self-debriefing. One technique, visualization, can be used for virtual practice. In the future, surgical simulators may allow for true virtual practice as well as systematic recording of results. However, psychomotor skills are only one component of surgical success. Intuition and innovation are also key, but these components are more difficult to teach and to learn. The key ingredient to successful practice and ultimate self-improvement in surgery, as in other pursuits in life, is that a person be self-motivated and competitive and have a strong desire to improve coupled with appropriate practice routines that can lead to improvement.
传统的传授方法在提高外科医生技能方面收效甚微。与其他成年人一样，外科医生通过实践、练习他们所做的事情以及挑战自己应对日益困难的情况来实现最佳学习效果。为了达到有效练习，外科手术实践需要将一个手术过程分解为关键要素，在进入下一个要素之前，每个要素都要反复练习，直到取得最佳效果。鉴于诸如全膝关节置换术等微创手术过程的多因素性质，外科医生需要在其手术环境中引入渐进式改变，以便在术后自我总结时进行实际的自我评估。一种技术，即可视化，可以用于虚拟练习。未来，手术模拟器可能会实现真正的虚拟练习以及对结果的系统记录。然而，心理运动技能只是手术成功的一个组成部分。直觉和创新也是关键，但这些组成部分更难教授和学习。与生活中的其他追求一样，手术成功实践和最终自我提升的关键因素是一个人要有自我驱动力和竞争力，有强烈的改进愿望，并辅以能够带来进步的适当练习常规。
