Department of Clinical Sciences, Division of Biostatistics, Southwestern Center for Minimally Invasive Surgery, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Surgery. 2010 Aug;148(2):194-201. doi: 10.1016/j.surg.2010.05.012. Epub 2010 Jul 1.
The purpose of this study was to determine 2-year performance retention and certification exam pass rate after completion of a proficiency-based fundamental laparoscopic skills (FLS) curriculum and subsequent interval training.
Surgery residents (postgraduate year [PGY]1-5, n = 91) were enrolled in an Institutional Review Board approved protocol. All participants initially underwent proficiency-based training on all 5 FLS tasks. Subsequently, available residents were enrolled every 6 months in an ongoing training curriculum that included retention tests on tasks 4 and 5, with mandatory retraining to proficiency if the proficiency levels were not achieved. The final retention test included the actual FLS certification examination for PGY4-5 trainees.
A 96% participation rate was achieved for all curricular components during the 2-year study period (PGY3-5, n = 33). Skill retention at retention 1-4 was 83%, 94%, 98%, and 91% for task 4 and 85%, 95%, 96%, and 100% for task 5, respectively. All PGY4-5 (n = 20) residents passed the FLS certification examination, achieving 413 +/- 28 total score on the skills portion (passing score > or =270) and demonstrating 92% retention for all 5 tasks.
Proficiency-based training with subsequent ongoing practice results in a very high level of skill retention after 2 years and uniformly allows trainees to pass the FLS certification examination.
本研究旨在确定完成基于熟练程度的基本腹腔镜技能(FLS)课程及后续间隔训练后,2 年的绩效保持率和认证考试通过率。
外科住院医师(1-5 年级,PGY,n = 91)参加了机构审查委员会批准的方案。所有参与者最初都接受了所有 5 项 FLS 任务的基于熟练程度的培训。随后,根据正在进行的培训课程,每 6 个月招募有空闲时间的住院医师,该课程包括第 4 项和第 5 项任务的保留测试,如果没有达到熟练水平,则必须重新进行熟练培训。最终的保留测试包括第 4-5 年级住院医师的实际 FLS 认证考试。
在 2 年的研究期间,所有课程组成部分的参与率均达到 96%(PGY3-5,n = 33)。保留 1-4 的技能保留率分别为第 4 项任务的 83%、94%、98%和 91%,第 5 项任务的 85%、95%、96%和 100%。所有第 4-5 年级的住院医师(n = 20)都通过了 FLS 认证考试,技能部分的总分为 413 +/- 28(通过分数> =270),所有 5 项任务的保留率为 92%。
基于熟练程度的培训加上随后的持续实践,可在 2 年后实现非常高的技能保留率,并使学员统一通过 FLS 认证考试。