Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Eur J Cardiothorac Surg. 2011 Mar;39(3):287-93. doi: 10.1016/j.ejcts.2010.06.035. Epub 2010 Aug 17.
The assessment of surgical competency has become a priority for both surgical educators and licensing boards. Surgical educators must incorporate rigorous, reliable, and valid means of assessment into residency programs. Objective evaluation of technical skills has been extensively explored in various surgical specialties, but its role in cardiac surgery has not been well studied and there is limited experience with integration into the educational curricula. Several cardiac and vascular surgery simulation models have been designed and evaluated, ranging from simple low-fidelity models using inert materials to a complex, computer-controlled, high-fidelity simulator using biological tissues to practice entire surgical cases. Most of the available models have not been well validated or integrated into educational curricula. The cardiac surgery simulation tools in development need validation and incorporation into structured, competency-based training curricula. The ongoing development of surgical simulators and educational curricula will enable a transition from the century-old graded responsibility training program to a competency-based program, where trainees must demonstrate technical competence to progress to the next level of training and gain certification and re-certification--ultimately ensuring better and faster technical skill acquisition as well as improved quality of care and patient safety.
外科能力评估已成为外科教育者和执照颁发机构的首要任务。外科教育者必须将严格、可靠和有效的评估手段纳入住院医师培训计划中。在各个外科专业中，已经广泛探索了对技术技能的客观评估，但它在心脏外科中的作用尚未得到充分研究，并且将其纳入教育课程的经验有限。已经设计和评估了几种心脏和血管外科模拟模型，范围从使用惰性材料的简单低保真模型到使用生物组织练习整个手术案例的复杂、计算机控制的高保真模拟器。大多数可用模型尚未得到很好的验证或纳入教育课程。正在开发的心脏手术模拟工具需要进行验证，并纳入到基于结构的能力培训课程中。外科模拟器和教育课程的不断发展将使我们能够从有百年历史的分级责任培训计划过渡到基于能力的培训计划，在该计划中，学员必须展示技术能力才能进入下一阶段的培训并获得认证和再认证，最终确保更好、更快地掌握技术技能以及提高护理质量和患者安全性。
