Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, 1650 Cedar Avenue, Room E19-117, Montreal, QC H3G 1A4, Canada.
Surg Endosc. 2011 Apr;25(4):1037-42. doi: 10.1007/s00464-010-1311-8. Epub 2010 Aug 24.
Existing literature on the acquisition of surgical skills suggests that women generally perform worse than men. This literature is limited by looking at an arbitrary number of trials and not adjusting for potential confounders. The objective of this study was to evaluate the impact of gender on the learning curve for a fundamental laparoscopic task.
Thirty-two medical students performed the FLS peg transfer task and their scores were plotted to generate a learning curve. Nonlinear regression was used to estimate learning plateau and learning rate. Variables that may affect performance were assessed using a questionnaire. Innate visual-spatial abilities were evaluated using tests for spatial orientation, spatial scanning, and perceptual abilities. Score on first peg transfer attempt, learning plateau, and learning rate were compared for men and women using Student's t test. Innate abilities were correlated to simulator performance using Pearson's coefficient. Multivariate linear regression was used to investigate the effect of gender on early laparoscopic performance after adjusting for factors found significant on univariate analysis. Statistical significance was defined as P < 0.05.
Nineteen men and 13 women participated in the study; 30 were right-handed, 12 reported high interest in surgery, and 26 had video game experience. There were no differences between men and women in initial peg transfer score, learning plateau, or learning rate. Initial peg transfer score and learning rate were higher in subjects who reported having a high interest in surgery (P = 0.02, P = 0.03). Initial score also correlated with perceptual ability score (P = 0.03). In multivariate analysis, only surgical interest remained a significant predictor of score on first peg transfer (P = 0.03) and learning rate (P = 0.02), while gender had no significant relationship to early performance.
Gender did not affect the learning curve for a fundamental laparoscopic task, while interest in surgery and perceptual abilities did influence early performance.
现有的外科技能习得文献表明，女性的表现通常不如男性。这些文献的局限性在于只观察了任意数量的试验，而没有对潜在的混杂因素进行调整。本研究的目的是评估性别对基本腹腔镜任务学习曲线的影响。
32 名医学生完成 FLS 钉转移任务，记录他们的得分以生成学习曲线。使用非线性回归来估计学习平台和学习率。使用问卷评估可能影响表现的变量。使用空间定向、空间扫描和感知能力测试评估先天视觉空间能力。使用学生 t 检验比较男性和女性的首次钉转移尝试得分、学习平台和学习率。使用 Pearson 系数将先天能力与模拟器表现相关联。使用多元线性回归在调整单因素分析中发现的有意义的因素后，研究性别对早期腹腔镜表现的影响。定义统计显著性为 P < 0.05。
19 名男性和 13 名女性参加了研究；30 名是右利手，12 名报告对手术有浓厚兴趣，26 名有视频游戏经验。男性和女性在初始钉转移得分、学习平台和学习率方面没有差异。报告对手术有浓厚兴趣的受试者的初始钉转移得分和学习率较高（P = 0.02，P = 0.03）。初始得分也与感知能力得分相关（P = 0.03）。多元分析仅显示手术兴趣仍然是首次钉转移得分（P = 0.03）和学习率（P = 0.02）的显著预测因素，而性别与早期表现没有显著关系。
性别对外科基本任务的学习曲线没有影响，而对手术的兴趣和感知能力确实会影响早期表现。
