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通过连续四周的模拟轮转,成功实施了美国外科医师学院/外科住院医师培训项目主任协会的外科技能课程。

Successful implementation of the american college of surgeons/association of program directors in surgery surgical skills curriculum via a 4-week consecutive simulation rotation.

机构信息

Division of Surgery Education, Department of Surgery, Hospitals of the University of Pennsylvania, Philadelphia, PA, USA.

出版信息

Simul Healthc. 2012 Jun;7(3):147-54. doi: 10.1097/SIH.0b013e31824120c6.

Abstract

INTRODUCTION

Increased patient awareness, duty hour restrictions, escalating costs, and time constraints in the operating room have revolutionized surgery education. Although simulation and skills laboratories are emerging as promising alternatives for skills training, their integration into graduate surgical education is inconsistent, erratic, and often on a voluntary basis. We hypothesize that, by implementing the American College of Surgeons/Association of Program Directors in Surgery Surgical Skills Curriculum in a structured, inanimate setting, we can address some of these concerns.

METHODS

Sixty junior surgery residents were assigned to the Penn Surgical Simulation and Skills Rotation. The National Surgical Skills Curriculum was implemented using multiple educational tools under faculty supervision. Pretraining and posttraining assessments of technical skills were conducted using validated instruments. Trainee and faculty feedbacks were collected using a structured feedback form.

RESULTS

Significant global performance improvement was demonstrated using Objective Structured Assessment of Technical Skills score for basic surgical skills (knot tying, wound closure, enterotomy closure, and vascular anastomosis) and Fundamentals of Laparoscopic Surgery skills, P < 0.001. Six trainees were retested on an average of 13.5 months later (range, 8-16 months) and retained more than 75% of their basic surgical skills.

DISCUSSION

The American College of Surgeons/Association of Program Directors in Surgery National Surgical Skills Curriculum can be implemented in its totality as a 4-week consecutive surgical simulation rotation in an inanimate setting, leading to global enhancement of junior surgical residents' technical skills and contributing to attainment of Accreditation Council for Graduate Medical Education core competency.

摘要

简介

患者意识的提高、工作时间限制、不断上涨的成本以及手术室中的时间限制,这些都彻底改变了外科学教育。尽管模拟和技能实验室作为技能培训的替代方法已经出现,但它们在研究生外科学教育中的整合是不一致的、不稳定的,而且往往是自愿的。我们假设,通过在一个结构化的、无生命的环境中实施美国外科医师学院/外科医师培训计划协会的外科技能课程,我们可以解决其中的一些问题。

方法

60 名初级外科住院医师被分配到宾夕法尼亚外科模拟和技能轮转中。在教员监督下,使用多种教育工具实施国家外科技能课程。使用经过验证的工具对技术技能进行培训前和培训后的评估。使用结构化反馈表收集学员和教员的反馈。

结果

使用客观结构化评估技术技能评分,对基本外科技能(打结、伤口闭合、肠切开闭合和血管吻合)和腹腔镜手术基础技能进行了显著的整体表现提高,P<0.001。6 名学员在平均 13.5 个月后(8-16 个月)进行了再次测试,保留了超过 75%的基本外科技能。

讨论

美国外科医师学院/外科医师培训计划协会国家外科技能课程可以作为一个为期 4 周的连续外科模拟轮转,在无生命的环境中全部实施,从而全面提高初级外科住院医师的技术技能,并有助于实现毕业后医学教育认证委员会的核心能力。

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