Department of Surgery, Toronto Western Hospital - University Health Network, 8th Floor, Main Pavilion, Room 325, Toronto, ON, Canada.
Surg Endosc. 2010 Feb;24(2):417-22. doi: 10.1007/s00464-009-0572-6. Epub 2009 Jun 30.
Several challenges exist with laparoscopic skills training in resource-restricted countries, including long travel distances required by mentors for onsite teaching. Telesimulation (TS) is a novel concept that uses the internet to link simulators between an instructor and a trainee in different locations. The purpose of this study was to determine the effectiveness of telesimulation for teaching the Fundamentals of Laparoscopic Surgery (FLS) to surgeons in Botswana, Africa.
A total of 16 surgeons from two centers in Botswana participated in this 8-week study. FLS TS was set up using two simulators, computers, webcams, and Skype software for eight surgeons in the TS group. A standard FLS simulator was available for the eight surgeons in the self-practice (SP) group. Participants in the TS group had one remote training session per week with an FLS proctor at the University of Toronto who provided feedback and demonstrated proper technique. Participants in the SP group had access to the FLS DVD and were instructed to train on FLS at least once per week. FLS post-test scores were obtained in Botswana by a trained FLS proctor at the conclusion of the study.
Participants in the TS group had significantly higher post-test FLS scores than those in the SP group (440 +/- 56 vs. 272 +/- 95, p = 0.001). All trainees in the TS group achieved an FLS simulator certification passing score, whereas only 38% in the SP group did so (p = 0.03).
Remote telesimulation is an effective method for teaching the Fundamentals of Laparoscopic Surgery in Africa, achieving a 100% FLS skills pass rate. This training platform provides a cost-effective method of teaching in resource-restricted countries and could be used to teach laparoscopic skills anywhere in the world with internet access.
在资源有限的国家，腹腔镜技能培训存在一些挑战，包括导师需要长途跋涉到现场进行教学。远程模拟（TS）是一种使用互联网将模拟器在不同地点的教员和学员连接起来的新概念。本研究的目的是确定远程模拟在教授非洲博茨瓦纳外科医生腹腔镜手术基础（FLS）方面的有效性。
共有来自博茨瓦纳的两个中心的 16 名外科医生参加了这项为期 8 周的研究。在远程模拟组中，使用两台模拟器、计算机、网络摄像头和 Skype 软件为 8 名外科医生建立了 FLS TS。标准的 FLS 模拟器可供 8 名自我练习（SP）组的外科医生使用。远程模拟组的参与者每周与多伦多大学的 FLS 主管进行一次远程培训，主管提供反馈并演示正确的技术。SP 组的参与者可以访问 FLS DVD，并被指示至少每周进行一次 FLS 训练。研究结束时，在博茨瓦纳由经过培训的 FLS 主管进行 FLS 后测试评分。
远程模拟组的参与者的 FLS 后测试评分明显高于 SP 组（440 +/- 56 对 272 +/- 95，p = 0.001）。远程模拟组的所有学员都通过了 FLS 模拟器认证考试，而 SP 组只有 38%的学员通过了考试（p = 0.03）。
远程模拟是在非洲教授腹腔镜手术基础的有效方法，实现了 100%的 FLS 技能通过率。这种培训平台为资源有限的国家提供了一种具有成本效益的教学方法，可以在任何有互联网接入的地方教授腹腔镜技能。
