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手术模拟器能否提高住院医师腹腔镜输卵管结扎术的手术操作水平?

Does a surgical simulator improve resident operative performance of laparoscopic tubal ligation?

作者信息

Banks Erika H, Chudnoff Scott, Karmin Ira, Wang Cuiling, Pardanani Setul

机构信息

Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.

出版信息

Am J Obstet Gynecol. 2007 Nov;197(5):541.e1-5. doi: 10.1016/j.ajog.2007.07.028.

Abstract

OBJECTIVE

The purpose of this study was to assess whether a surgical skills simulator laboratory improves resident knowledge and operative performance of laparoscopic tubal ligation.

STUDY DESIGN

Twenty postgraduate year 1 residents were assigned randomly to either a surgical simulator laboratory on laparoscopic tubal ligation together with apprenticeship teaching in the operating room or to apprenticeship teaching alone. Tests that were given before and after the training assessed basic knowledge. Attending physicians who were blinded to resident randomization status evaluated postgraduate year 1 performance on a laparoscopic tubal ligation in the operating room with 3 validated tools: a task-specific checklist, global rating scale, and pass/fail grade.

RESULTS

Postgraduate year 1 residents who were assigned randomly to the surgical simulator laboratory performed significantly better than control subjects on all 3 surgical assessment tools (the checklist, the global score, and the pass/fail analysis) and scored significantly better on the knowledge posttest (all P < .0005).

CONCLUSION

Compared with apprenticeship teaching alone, a surgical simulator laboratory on laparoscopic tubal ligation improved resident knowledge and performance in the operating room.

摘要

目的

本研究旨在评估手术技能模拟实验室是否能提高住院医师在腹腔镜输卵管结扎术方面的知识水平和手术操作表现。

研究设计

20名一年级住院医师被随机分配到两组,一组参与腹腔镜输卵管结扎术的手术模拟实验室培训并在手术室接受带教,另一组仅接受手术室带教。培训前后进行测试以评估基础知识。对住院医师随机分组情况不知情的主治医生,使用3种经过验证的工具,在手术室对一年级住院医师的腹腔镜输卵管结扎术表现进行评估:特定任务清单、整体评分量表和通过/失败评分。

结果

随机分配到手术模拟实验室的一年级住院医师在所有3种手术评估工具(清单、整体评分和通过/失败分析)上的表现均显著优于对照组,且在知识后测中的得分也显著更高(所有P < .0005)。

结论

与单纯的带教相比,腹腔镜输卵管结扎术的手术模拟实验室提高了住院医师在手术室的知识水平和操作表现。

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