Department of Surgery, Stanford University Medical Center, 780 Welch Road, Stanford, CA 94024, USA.
J Am Coll Surg. 2010 Jun;210(6):984-9. doi: 10.1016/j.jamcollsurg.2010.03.006.
Surgical interns enter residency with variable technical abilities and many feel unprepared to perform necessary procedures. We hypothesized that interns exposed to a preinternship intensive surgical skills curriculum would demonstrate improved competency over unexposed colleagues on a test of surgical skills and that this effect would persist throughout internship.
We designed a 3-day intensive skills "boot camp" with simulation-based training on 10 topics. Interns were randomized to an intervention group (boot camp) or a control group (no boot camp). All interns completed a survey including demographic information, previous experience, and comfort with basic surgical skills. Both groups completed a clinical skills assessment focused on 4 topics: chest tube insertion, central line placement, wound closure, and the Fundamentals of Laparoscopic Surgery peg transfer task. We assessed both groups immediately (month 0), early postcurriculum (month 1), and late postcurriculum (month 6).
Fifteen participants were in the intervention group and 13 were in the control group. Before boot camp, mean comfort levels were similar for the groups. All participants had minimal prior experience. Competency for chest tube insertion and central line placement were considerably higher for the boot camp group at months 0 and 1, although much of this difference disappeared by month 6. There was no substantial difference between the 2 groups in the Fundamentals of Laparoscopic Surgery peg transfer and wound closure skills.
A surgical skills boot camp accelerates the learning curve for interns in basic surgical skills as measured by a technical skills examination for some skills, although these improvements diminished over time. This can augment traditional training and translate into fewer patient errors.
外科实习医生在进入住院实习期时具有不同的技术能力，许多人觉得自己没有准备好进行必要的手术。我们假设，接受岗前强化外科技能课程的实习医生在外科技能测试中的表现会比没有接受过培训的同事更有竞争力，而且这种效果会在整个实习期内持续存在。
我们设计了一个为期 3 天的强化技能“训练营”，内容包括 10 个主题的模拟培训。实习医生被随机分配到干预组（训练营）或对照组（无训练营）。所有实习医生都完成了一份包括人口统计学信息、先前经验和基本手术技能舒适度的调查。两组都完成了一项临床技能评估，重点评估 4 个主题：胸腔引流管插入、中心静脉置管、伤口缝合和腹腔镜手术基本技能 peg 转移任务。我们在立即（第 0 个月）、课程结束后早期（第 1 个月）和课程结束后晚期（第 6 个月）对两组进行评估。
干预组有 15 名参与者，对照组有 13 名参与者。在训练营之前，两组的舒适度水平相似。所有参与者的先前经验都很少。在第 0 个月和第 1 个月，训练营组的胸腔引流管插入和中心静脉置管的技能水平明显更高，尽管到第 6 个月，这种差异大部分已经消失。在腹腔镜手术基本技能 peg 转移和伤口缝合技能方面，两组之间没有实质性差异。
外科技能训练营可以加速实习医生在某些技能方面的基本外科技能学习曲线，通过技术技能考试来衡量，但这些改进随着时间的推移而减弱。这可以补充传统培训，并减少患者错误。
