Zheng B, Denk P M, Martinec D V, Gatta P, Whiteford M H, Swanström L L
Minimally Invasive Surgery Program, Legacy Health System, 1040 NW 22nd Avenue, Suite 560, Portland, OR 97210, USA.
Surg Endosc. 2008 Apr;22(4):930-7. doi: 10.1007/s00464-007-9524-1. Epub 2007 Aug 19.
Complex laparoscopic tasks require collaboration of surgeons as a surgical team. Conventionally, surgical teams are formed shortly before the start of the surgery, and team skills are built during the surgery. There is a need to establish a training simulation to improve surgical team skills without jeopardizing the safety of surgery. The Legacy Inanimate System for Laparoscopic Team Training (LISETT) is a bench simulation designed to enhance surgical team skills. The reported project tested the construct validity of LISETT. The research question was whether the LISETT scores show progressive improvement correlating with the level of surgical training and laparoscopic team experience or not.
With LISETT, two surgeons are required to work closely to perform two laparoscopic tasks: peg transportation and suturing. A total of 44 surgical dyad teams were recruited, composed of medical students, residents, laparoscopic fellows, and experienced surgeons. The LISETT scores were calculated according to the speed and accuracy of the movements.
The LISETT scores were positively correlated with surgical experience, and the results can be generalized confidently to surgical teams (Pearson's coefficient, 0.73; p = 0.001). To analyze the influences of individual skill and team dynamics on LISETT performance, team quality was rated by team members using communication and cooperation characters after each practice. The LISETT scores are positively correlated with self-rated team quality scores (Pearson's coefficient, 0.39; p = 0.008).
The findings proved LISETT to be a valid system for assessing cooperative skills of a surgical team. By increasing practice time, LISETT provides an opportunity to build surgical team skills, which include effective communication and cooperation.
复杂的腹腔镜手术任务需要外科医生作为一个手术团队进行协作。传统上,手术团队在手术开始前不久组建,团队技能在手术过程中培养。需要建立一种训练模拟方法,以提高手术团队技能,同时不危及手术安全。腹腔镜团队训练传统无生命系统(LISETT)是一种旨在提高手术团队技能的实验台模拟系统。本报告的项目测试了LISETT的结构效度。研究问题是LISETT分数是否显示出与外科培训水平和腹腔镜团队经验水平相关的渐进性提高。
使用LISETT时,需要两名外科医生密切合作完成两项腹腔镜任务:移钉和缝合。共招募了44个手术二人组团队,成员包括医学生、住院医师、腹腔镜研究员和经验丰富的外科医生。根据动作的速度和准确性计算LISETT分数。
LISETT分数与手术经验呈正相关,结果可以可靠地推广到手术团队(皮尔逊系数,0.73;p = 0.001)。为了分析个人技能和团队动态对LISETT表现的影响,团队成员在每次练习后使用沟通和合作特征对团队质量进行评分。LISETT分数与自我评定的团队质量分数呈正相关(皮尔逊系数,0.39;p = 0.008)。
研究结果证明LISETT是评估手术团队合作技能的有效系统。通过增加练习时间,LISETT提供了培养手术团队技能的机会,其中包括有效的沟通与合作。