Lund Lars, Høj Lars, Poulsen Johan, Funch-Jensen Peter, Nilsson Tove
Urologisk Afdeling, Regionshospitalet Viborg, DK-8800 Viborg, Denmark.
Ugeskr Laeger. 2010 Feb 8;172(6):436-40.
Training, development and implementation of minimally invasive surgery is resource-demanding. The new Danish specialist training programme combined with shorter employment periods and working hours have increased the need for a more efficient education, training and certification of surgery, gynaecology and urology trainees.
A total of 106 trainees who were non-specialised doctors from a region in Denmark underwent theoretical as well as practical specialised training in laparoscopy in the period 2006-2008. The training had several modules of which the two first are described. The training and evaluation methods used were objective, structured clinical examination (OSCE-test) and objective skill assessments tests (OSATS-test).
Among the 108 trainees, a total of 80 physicians passed. On module 1, the distribution of participants with regards to speciality was: surgery 47 physicians, urology 14 physicians and gynaecology 45 physicians. Six physicians were not certified. We have registered OSATS-scores for 64 participants with a median score of 3.0 (range 1-4.4). To pass, the multiple choice test participants needed to answer 66% of the questions correctly. Below this level were 20 participants out of 57 (35%) on module 1 and 32 out of 60 (53%) on module 2.
Thanks to political attention and sufficient financing a centre without physical premises has been established. It has been possible to offer training to young surgeons during their first year with both benchmark training and live operations in animal models. The concept may also be used by the trainee as guidance when making education and career choices.
微创手术的培训、发展和实施需要大量资源。丹麦新的专科培训计划,再加上较短的就业期限和工作时间,增加了对手术、妇科和泌尿外科实习生进行更高效教育、培训和认证的需求。
2006年至2008年期间,丹麦某地区共有106名非专科医生实习生接受了腹腔镜检查的理论和实践专科培训。培训有几个模块,其中前两个模块在此描述。所采用的培训和评估方法是客观结构化临床考试(OSCE测试)和客观技能评估测试(OSATS测试)。
在108名实习生中,共有80名医生通过。在模块1中,按专业划分的参与者分布为:外科47名医生,泌尿外科14名医生,妇科45名医生。6名医生未获得认证。我们记录了64名参与者的OSATS分数,中位数为3.0(范围1 - 4.4)。要通过,多项选择题测试的参与者需要正确回答66%的问题。在模块1中,57名参与者中有20名(35%)低于此水平,在模块2中,60名参与者中有32名(53%)低于此水平。
由于政治关注和充足的资金,一个没有实体场所的中心得以建立。在年轻外科医生的第一年就有可能为他们提供培训,包括基准培训和动物模型的现场手术。该概念也可被实习生用作教育和职业选择的指导。