乳腺外科医生的结构化超声工作坊：它是一种有效的培训工具吗？

Structured ultrasonography workshop for breast surgeons: is it an effective training tool?

机构信息

Breast and Endocrine Surgery Unit, Princess Alexandra Hospital, 199 Ipswich Road, Buranda, QLD, 4102, Australia.

出版信息

World J Surg. 2010 Mar;34(3):549-54. doi: 10.1007/s00268-009-0342-6.

DOI:10.1007/s00268-009-0342-6

PMID:20054545

Abstract

BACKGROUND

Effective training is essential to ensure satisfactory performance in surgeon-performed ultrasonography (US) and guided breast needle biopsies (USGBB). This study aimed to determine the efficacy of conducting a structured workshop in the teaching of breast US application and in guided biopsy techniques.

METHODS

Consenting participants of the US for Surgeons Workshop at the General Surgeons Australia 2008 Annual Scientific Meeting were recruited. The workshop was divided into theoretical and practical components. For the theoretical component, brief pretests were administered, followed by lecture series, and then posttests. For the practical component, preinstructional USGBBs performed on breast phantoms and turkey breasts implanted with simulated lesions were assessed, followed by tutorials; it was concluded with postinstructional biopsy assessment. Points were deducted for simulated chest wall hits (complications). Previous experience and training in USBGG were recorded. Pre- and postlecture/instructional results were compared and the correlation tested using Student's t-test (p < 0.05).

RESULTS

In all, 14 participants were recruited: 71% had no to moderate experience with USGBB. For the theoretical component, 33% improvement over the pretest (p < 0.001) was seen across all levels of experience. For the practical component, there was 56% improvement after instruction (p = 0.001), which was most marked in the moderate experience group (83%, p = 0.03). Two complications were recorded for the least experienced group prior to instructions, but no complications were seen following instructions.

CONCLUSIONS

Structured workshops are effective for training surgeons in US application and USGBB and should be considered as part of standardized training guidelines and credentialing. Theory and practical components demonstrated similar efficacy and should be considered integral components in training programs. Formal training decreases complication rates, especially among the inexperienced.

摘要

背景

有效的培训对于确保外科医生执行超声检查（US）和引导性乳房针吸活检（USGBB）的满意表现至关重要。本研究旨在确定在教授乳房 US 应用和引导性活检技术方面进行结构化研讨会的效果。

方法

在 2008 年澳大利亚普通外科医生年度科学会议上，对参加外科医生超声研讨会的同意参与者进行了招募。该研讨会分为理论和实践两部分。对于理论部分，先进行简短的预测试，然后进行一系列讲座，最后进行后测试。对于实践部分，先在乳房模型和植入模拟病变的火鸡胸脯上进行预指导的 USGBB，然后进行教程；最后进行指导后的活检评估。因模拟胸壁撞击（并发症）而扣分。记录了之前在 USBGG 方面的经验和培训。比较了课前/指导前后的结果，并使用学生 t 检验（p < 0.05）进行了相关性检验。

结果

共招募了 14 名参与者：71%的参与者仅有或中等程度的 USGBB 经验。对于理论部分，所有经验水平的参与者在课前测试中均有 33%的提高（p < 0.001）。对于实践部分，指导后有 56%的提高（p = 0.001），其中中等经验组的提高最为显著（83%，p = 0.03）。在指导之前，经验最少的组有 2 例并发症记录，但在指导之后没有并发症记录。