腹腔镜模拟训练与熟练目标提高新手外科医生的实践和表现。
Laparoscopic simulation training with proficiency targets improves practice and performance of novice surgeons.
机构信息
Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.
出版信息
Am J Surg. 2010 Jan;199(1):72-80. doi: 10.1016/j.amjsurg.2009.07.034.
BACKGROUND
This study compares a laparoscopic skill training protocol without proficiency targets to the same protocol with explicit targets and notification of progress.
METHODS
Fourteen surgery interns were randomized into 2 groups. The intervention group received task-specific proficiency criteria to guide practice. The control group did not. After training, participants were evaluated by blinded faculty during laparoscopic cholecystectomy.
RESULTS
The control group met significantly fewer of the 7 LapSim (Surgical Science Sweden AB, Gotëborg) targets (mean = 1.14) than the intervention group (mean = 7.00; P = .001) and significantly fewer of the 5 video trainer targets (mean = .86) than the intervention group (mean = 5.00; P = .001). Ratings of depth perception, bimanual dexterity, efficiency, tissue handling, autonomy, and overall competence were higher for the intervention group. Effect sizes ranged from medium to large (.394-.981), indicating an impact of the proficiency-based training protocol.
CONCLUSIONS
Delineation of proficiency targets with reporting of progress improves interns' practice results, and appears to have a positive effect on their early operating room (OR) performance of laparoscopic cholecystectomy.
背景
本研究比较了一种无熟练度目标的腹腔镜技能训练方案与具有明确目标和进度通知的相同方案。
方法
将 14 名外科实习医生随机分为两组。干预组接受特定任务的熟练度标准来指导实践。对照组则没有。培训后，由盲法教员在腹腔镜胆囊切除术期间对参与者进行评估。
结果
对照组在 LapSim（瑞典 Surgical Science AB，哥德堡）目标中满足的目标明显少于干预组（平均值为 7.00；P =.001），在视频训练器目标中满足的目标明显少于干预组（平均值为 5.00；P =.001）。干预组的深度知觉、双手灵巧性、效率、组织处理、自主性和整体能力的评分更高。效应大小范围从中等到大（.394-.981），表明基于熟练度的培训方案具有影响。
结论
明确熟练度目标并报告进度可以提高实习医生的实践结果，并似乎对他们在早期手术室（OR）进行腹腔镜胆囊切除术的表现有积极影响。
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