Dhariwal Anender Kaur, Prabhu Ramkrishna Y, Dalvi Abhay N, Supe Avinash N
Department of Surgical Gastroenterology, Seth GS Medical College and KEM Hospital, Parel, Mumbai - 400 012, India.
J Minim Access Surg. 2007 Apr;3(2):57-63. doi: 10.4103/0972-9941.33274.
Various devices are used to aid in the education of laparoscopic skills ranging from simple box trainers to sophisticated virtual reality trainers. Virtual reality system is an advanced and effective training method, however it is yet to be adopted in India due to its cost and the advanced technology required for it. Therefore, box trainers are being used to train laparoscopic skills. Hence this study was undertaken to assess the overall effectiveness of the box-training course. STUDY PROCEDURE: The study was conducted during six-day laparoscopic skills training workshops held during 2006. Twenty five surgeons; age range of 26 to 45 years, of either sex, who had not performed laparoscopic surgery before; attending the workshop were evaluated. Each participant was given a list of tasks to perform before beginning the box-training course on day one and was evaluated quantitatively by rating the successful completion of each test. Evaluation began when the subject placed the first tool into the cannula and ended with task completion. Two evaluation methods used to score the subject, including a global rating scale and a task-specific checklist. After the subject completed all sessions of the workshop, they were asked to perform the same tasks and were evaluated in the same manner. For each task completed by the subjects, the difference in the scores between the second and first runs were calculated and interpreted as an improvement as a percentage of the initial score.
Wilcoxon matched-paired signed-ranks test was applied to find out the statistical significance of the results obtained.
The mean percentage improvement in scores for both the tasks, using global rating scale, was 44.5% ± 6.930 (Mean ± SD). For task 1, using the global rating scale mean percentage improvement was 49.4% ± 7.948 (Mean ± SD). For task 2, mean percentage improvement using global rating scale was 39.6% ± 10.4 (Mean ± SD). Using Wilcoxon matched-paired signed-ranks test, 2-tailed P-value<0.0001 which is extremely significant.
This study confirms that a short-term, intensive, focused course does improve laparoscopic skills of trainees. Box-trainers can be used to change the present day didactic training into objective and competency-based. Global rating scale and checklist provide an inexpensive and effective way of objective assessment of performance of laparoscopic skills.
从简单的箱式训练器到复杂的虚拟现实训练器，有各种各样的设备用于辅助腹腔镜技能培训。虚拟现实系统是一种先进且有效的训练方法，但由于其成本以及所需的先进技术，在印度尚未得到应用。因此，箱式训练器被用于培训腹腔镜技能。故而开展本研究以评估箱式训练课程的整体效果。
本研究在2006年举办的为期六天的腹腔镜技能培训工作坊期间进行。对25名年龄在26至45岁之间、此前未进行过腹腔镜手术的男女外科医生进行了评估，这些医生均参加了该工作坊。在第一天开始箱式训练课程之前，给每位参与者一份任务清单，通过对每项测试的成功完成情况进行评分来进行定量评估。评估从受试者将第一个工具放入套管开始，到任务完成结束。使用两种评估方法对受试者进行评分，包括整体评分量表和特定任务清单。在受试者完成工作坊的所有课程后，要求他们执行相同的任务，并以相同的方式进行评估。对于受试者完成的每项任务，计算第二次和第一次操作得分之间的差异，并将其解释为相对于初始得分的提高百分比。
应用Wilcoxon配对符号秩检验来确定所得结果的统计学意义。
使用整体评分量表，两项任务得分的平均提高百分比为44.5%±6.930（均值±标准差）。对于任务1，使用整体评分量表的平均提高百分比为49.4%±7.9
