Nomura Tsutomu, Miyashita Masao, Shrestha Suman, Makino Hiroshi, Nakamura Yoshiharu, Aso Ryouko, Yoshimura Akinobu, Shimura Toshiro, Akira Shigeo, Tajiri Takashi
Department of Surgery, Nippon Medical School, Tokyo, Japan.
J Surg Educ. 2008 Sep-Oct;65(5):335-9. doi: 10.1016/j.jsurg.2008.07.008.
Our institute started laparoscopic simulator training for medical students in 2006. During the training, we observed considerable interindividual differences in laparoscopic skills among those students. This study aimed to investigate the predictive factors that affect laparoscopic skill by assessing the students' training results data.
Forty-three, fifth-year medical students were asked several questions and were divided into 2 groups depending on their answers. The participants performed an object-positioning module on a ProMIS simulator (Haptica, Inc., Dublin, Ireland). Execution time, instrument path length, and economy of movement for each trial were recorded on ProMIS. Comparisons of mean performance measures between the 2 groups were made using a Mann-Whitney U test.
Interest about laparoscopic surgery and accomplishment in playing piano did not affect the skillfulness significantly. The students who had an interest in television (TV) games completed the task in less time (p = 0.046) and had a shorter left instrument path length (p = 0.012). The students who thought themselves manually dexterous completed the task in less time (p = 0.008). The students who were confident about driving completed the task in less time (p = 0.0247).
In our interview, the factors that had a relationship to laparoscopic skills were favorableness to TV games, manual dexterity, and confidence about driving. These results were expected because TV games and driving a car require the same abilities as laparoscopic surgery. Psychomotor, perceptual, or visuospatial ability are essential for good performance. In conclusion, our study suggests that the interview can be an effective measure to examine the aptitude of medical students without the use of a simulator.
我院于2006年开始对医学生进行腹腔镜模拟器培训。在培训过程中，我们观察到这些学生在腹腔镜技能方面存在显著的个体差异。本研究旨在通过评估学生的培训结果数据来调查影响腹腔镜技能的预测因素。
向43名五年级医学生提出了几个问题，并根据他们的回答将其分为两组。参与者在ProMIS模拟器（爱尔兰都柏林的Haptica公司）上执行一个物体定位模块。每次试验的执行时间、器械路径长度和动作经济性都记录在ProMIS上。使用Mann-Whitney U检验对两组之间的平均性能指标进行比较。
对腹腔镜手术的兴趣和弹钢琴的造诣对技能熟练程度没有显著影响。对电视游戏感兴趣的学生完成任务的时间更短（p = 0.046），左器械路径长度更短（p = 0.012）。认为自己手部灵巧的学生完成任务的时间更短（p = 0.008）。对驾驶有信心的学生完成任务的时间更短（p = 0.0247）。
在我们的访谈中，与腹腔镜技能相关的因素是对电视游戏的偏好、手部灵巧性和对驾驶的信心。这些结果在意料之中，因为电视游戏和驾驶汽车所需的能力与腹腔镜手术相同。心理运动、感知或视觉空间能力对于良好的表现至关重要。总之，我们的研究表明，访谈可以成为一种在不使用模拟器的情况下检验医学生能力倾向的有效方法。
