Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
Surg Endosc. 2011 Jul;25(7):2261-7. doi: 10.1007/s00464-010-1545-5. Epub 2011 Feb 27.
The transition from basic skills training in a skills lab to procedure training in the operating theater using the traditional master-apprentice model (MAM) lacks uniformity and efficiency. When the supervising surgeon performs parts of a procedure, training opportunities are lost. To minimize this intervention by the supervisor and maximize the actual operating time for the trainee, we created a new training method called INtraoperative Video-Enhanced Surgical Training (INVEST).
Ten surgical residents were trained in laparoscopic cholecystectomy either by the MAM or with INVEST. Each trainee performed six cholecystectomies that were objectively evaluated on an Objective Structured Assessment of Technical Skills (OSATS) global rating scale. Absolute and relative improvements during the training curriculum were compared between the groups. A questionnaire evaluated the trainee's opinion on this new training method.
Skill improvement on the OSATS global rating scale was significantly greater for the trainees in the INVEST curriculum compared to the MAM, with mean absolute improvement 32.6 versus 14.0 points and mean relative improvement 59.1 versus 34.6% (P=0.02).
INVEST significantly enhances technical and procedural skill development during the early learning curve for laparoscopic cholecystectomy. Trainees were positive about the content and the idea of the curriculum.
从技能实验室的基本技能培训过渡到传统师徒模式（MAM）下的手术室程序培训缺乏统一性和效率。当主管外科医生执行手术的部分程序时，培训机会就会丧失。为了减少主管的这种干预，并使学员有更多的实际操作时间，我们创建了一种新的培训方法，称为术中视频增强手术培训（INVEST）。
10 名外科住院医师通过 MAM 或 INVEST 接受腹腔镜胆囊切除术培训。每位学员进行了 6 次腹腔镜胆囊切除术，这些手术均通过客观的技能评估（OSATS）全球评分量表进行客观评估。比较两组学员在培训课程中的绝对和相对进步。通过问卷调查评估学员对这种新培训方法的看法。
与 MAM 相比，在 INVEST 课程中，学员在 OSATS 全球评分量表上的技能提升幅度明显更大，平均绝对提高 32.6 分，相对提高 59.1%，而 MAM 为 14.0 分和 34.6%（P=0.02）。
INVEST 显著增强了腹腔镜胆囊切除术早期学习曲线期间的技术和程序技能发展。学员对课程内容和理念持积极态度。
