Jensen Aaron R, Wright Andrew S, Levy Adam E, McIntyre Lisa K, Foy Hugh M, Pellegrini Carlos A, Horvath Karen D, Anastakis Dimitri J
Department of Surgery, University of Washington, School of Medicine, Room BB-487, 1959 NE Pacific St., Box 356410, Seattle, WA 98195, USA.
Am J Surg. 2009 Jan;197(1):82-8. doi: 10.1016/j.amjsurg.2008.06.039.
We evaluated the impact of expert instruction during laboratory-based basic surgical skills training on subsequent performance of more complex surgical tasks.
Forty-five junior residents were randomized to learn basic surgical skills in either a self-directed or faculty-directed fashion. Residents returned to the laboratory 2 days later and were evaluated while performing 2 tasks: skin closure and bowel anastomosis. Outcome measures included Objective Structured Assessment of Technical Skill, time to completion, final product quality, and resident perceptions.
Objective Structured Assessment of Technical Skill, time to completion, and skin esthetic ratings were not better in the faculty-directed group, although isolated improvement in anastomotic leak pressure was seen. Residents perceived faculty-directed training to be superior.
Our data provided minimal objective evidence that faculty-directed training improved transfer of learned skills to more complex tasks. Residents perceived that there was a benefit of faculty mentoring. Curriculum factors related to training of basic skills and subsequent transfer to more complex tasks may explain these contrasting results.
我们评估了在基于实验室的基本外科技能培训期间专家指导对后续更复杂外科任务表现的影响。
45名初级住院医师被随机分为以自主学习或教师指导的方式学习基本外科技能。住院医师在2天后返回实验室，并在执行两项任务（皮肤缝合和肠吻合术）时接受评估。结果指标包括客观结构化技术技能评估、完成时间、最终产品质量和住院医师的看法。
尽管在吻合口漏压力方面有单独的改善，但教师指导组在客观结构化技术技能评估、完成时间和皮肤美观评分方面并没有更好。住院医师认为教师指导的培训更优越。
我们的数据提供了极少的客观证据表明教师指导的培训能将所学技能更好地转移到更复杂的任务中。住院医师认为教师指导有益。与基本技能培训及随后向更复杂任务的转移相关的课程因素可能解释了这些相互矛盾的结果。
