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外科住院医师的技术技能轮转。

Technical skills rotation for general surgery residents.

机构信息

Center of Excellence for Laparoscopic and Minimally Invasive Surgery, Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.

出版信息

J Surg Res. 2010 Jun 15;161(2):179-82. doi: 10.1016/j.jss.2009.09.009. Epub 2009 Sep 30.

Abstract

BACKGROUND

Technical skills are an important part of any general surgery residency curriculum. With the demands of limited work weeks, it is imperative that educators create novel methods of teaching technical skills to their residents. Our program utilizes a dedicated month to help accomplish this. This study hypothesized that general surgery residents would report a positive effect of a dedicated technical skills rotation.

METHODS

Residents who had undergone a 1 mo rotation in technical skills during their first year were asked to fill out a survey concerning their experience. During the 1-mo rotation, the residents had almost no clinical responsibilities. Teaching of technical skills was performed with various activities, including video content (VC), virtual reality simulators (VR), open foam procedures (OF), laparoscopic box trainers (BT), surgical equipment in-service (SE), and animate sessions (AS). Responses were given on a Likert scale (1-10) with higher numbers being more positive responses.

RESULTS

There were seven residents in this study. The residents gave a very positive response to the overall rotation (9.4) and exposure to laparoscopic procedures (9.6). The other responses were enthusiastic as well: exposure to open procedures (8.9) and preparation for operative room (9.4). After their rotation, the residents were comfortable performing a laparoscopic cholecystectomy (9.2), a hand-sewn anastomosis (8.7), and a stapled anastomosis (9.4). The residents found theses activities helpful in increasing order: VC (7.8), VR (8.0), BT (9.0), ES (9.7), OF (9.8), and AS (9.8).

CONCLUSIONS

A 1-mo dedicated technical skills rotations was perceived to be extremely positive by the residents. The residents felt very comfortable performing a laparoscopic cholecystectomy, a hand-sewn anastomosis, and a stapled anastomosis. With the 80-h work week, alternatives to learning technical skills in the operating room are essential. Further studies need to be performed to determine if this rotation aids in accomplishing this goal.

摘要

背景

技术技能是普通外科住院医师培训课程的重要组成部分。由于工作周时间有限,教育者必须创造新的方法来向住院医师传授技术技能。我们的计划利用一个专门的月份来帮助实现这一目标。本研究假设普通外科住院医师会报告专门的技术技能轮转对他们有积极的影响。

方法

在第一年接受过 1 个月技术技能轮转的住院医师被要求填写一份关于他们经验的调查。在 1 个月的轮转中,住院医师几乎没有临床职责。技术技能的教学是通过各种活动进行的,包括视频内容 (VC)、虚拟现实模拟器 (VR)、开放式泡沫程序 (OF)、腹腔镜箱式训练器 (BT)、外科设备在役 (SE) 和动画课程 (AS)。回答是在李克特量表上给出的(1-10),数字越高表示回答越积极。

结果

本研究共有 7 名住院医师。住院医师对整个轮转(9.4)和腹腔镜手术的暴露(9.6)给予了非常积极的评价。其他反应也很热烈:开放手术的暴露(8.9)和手术室的准备(9.4)。在轮转结束后,住院医师对腹腔镜胆囊切除术(9.2)、手工吻合术(8.7)和吻合钉吻合术(9.4)的操作感到舒适。住院医师认为这些活动的帮助程度依次为:VC(7.8)、VR(8.0)、BT(9.0)、ES(9.7)、OF(9.8)和 AS(9.8)。

结论

住院医师认为为期 1 个月的专门技术技能轮转非常积极。住院医师对腹腔镜胆囊切除术、手工吻合术和吻合钉吻合术的操作非常熟练。在每周 80 小时的工作时间内,学习手术室技术技能的替代方法至关重要。需要进一步研究以确定该轮转是否有助于实现这一目标。

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