Mathis Kellie L, Wiegmann Douglas A
Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN55905, USA.
Simul Healthc. 2007 Fall;2(3):178-82. doi: 10.1097/SIH.0b013e318137aba1.
Laparoscopic simulators are increasingly used to train and evaluate surgical skill, and validating laparoscopic simulators for these purposes is paramount. Our goal was to determine if the SurgicalSIM laparoscopic surgical simulator can discriminate between novices and experts and to assess learning curves among novices.
Twenty novices and five experts performed five repetitions on the following modules: place arrow, retract, dissect, and traverse tube. For each module, median baseline performance was calculated. Novices performed 35 additional repetitions to assess learning with practice.
Experts outperformed novices at baseline for time to completion on the dissect, place arrow, and traverse tube modules, as well as for error frequency on the traverse tube and retract modules. Novices' performance improved significantly with practice, approaching the experts' baseline in all modules.
The SurgicalSIM laparoscopic simulator exhibits construct validity on three of four basic-skills modules when considering completion time and on two modules when considering error frequency. Among novices, learning occurred with additional repetitions. Whether acquired skills transfer to the actual surgical environment has yet to be determined.
腹腔镜模拟器越来越多地用于训练和评估手术技能，为此类目的验证腹腔镜模拟器至关重要。我们的目标是确定SurgicalSIM腹腔镜手术模拟器能否区分新手和专家，并评估新手的学习曲线。
20名新手和5名专家对以下模块进行了5次重复操作：放置箭头、牵拉、解剖和穿过管道。对于每个模块，计算了基线表现的中位数。新手又进行了35次重复操作以评估练习中的学习情况。
在解剖、放置箭头和穿过管道模块的完成时间方面，以及在穿过管道和牵拉模块的错误频率方面，专家在基线时的表现优于新手。新手的表现随着练习有显著提高，在所有模块中接近专家的基线水平。
考虑完成时间时，SurgicalSIM腹腔镜模拟器在四个基本技能模块中的三个上表现出结构效度；考虑错误频率时，在两个模块上表现出结构效度。在新手当中，通过额外的重复操作实现了学习。所获得的技能能否转移到实际手术环境中还有待确定。
