Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada.
BJOG. 2012 Aug;119(9):1040-8. doi: 10.1111/j.1471-0528.2012.03398.x. Epub 2012 Jun 7.
To evaluate the role of mental imagery (MI) in resident training for a complex surgical procedure.
Randomised controlled trial.
Eight centres across Canada and the USA.
Junior gynaecology residents who had performed fewer than five vaginal hysterectomies (VH).
After performing a pretest VH, junior gynaecology residents were randomised to standard MI versus textbook reading (No MI) and then performed a test VH. Surgeons blinded to group evaluated resident performance on the pretest and test VH via global rating scales (GRS), procedure-specific scales and intraoperative parameters. Residents evaluated their own performance.
Change in surgeon GRS score from pretest to test VH. The study was powered to detect a 20% difference in score change.
Fifty residents completed the trial (24 MI, 26 No MI). There was no difference in GRS score change via blinded assessment from pretest to test evaluation between groups (mean change 13% [SD 17] versus 7% [SD 14], P = 0.192). There was no difference in procedure-specific score change. There was a significant difference in self-scored GRS score change between groups (mean change 19% [SD 12] versus 9% [SD 11], P = 0.005). Residents also felt more confident performing a VH (mean change 19% [SD 16] MI versus 11% [SD 10] No MI, P = 0.033).
No difference was observed in the surgical performance of residents after MI. Improved resident self-confidence may be attributable to MI or the effect of unblinding on trial participants.
评估心理意象（MI）在复杂手术住院医师培训中的作用。
随机对照试验。
加拿大和美国的 8 个中心。
进行阴道子宫切除术（VH）少于 5 次的初级妇科住院医师。
在进行预测试 VH 后，初级妇科住院医师被随机分为标准 MI 组与教科书阅读组（无 MI 组），然后进行测试 VH。对手术医生进行分组设盲，通过整体评估量表（GRS）、手术特定量表和术中参数评估住院医师在预测试和测试 VH 中的表现。住院医师评估自己的表现。
从预测试到测试 VH，外科医生 GRS 评分的变化。该研究的功率足以检测评分变化 20%的差异。
50 名住院医师完成了试验（MI 组 24 名，无 MI 组 26 名）。两组间从预测试到测试评估，GRS 评分变化的盲法评估无差异（平均变化 13%[SD 17]与 7%[SD 14]，P = 0.192）。手术特定评分变化无差异。两组间 GRS 评分的自我评分变化有显著差异（平均变化 19%[SD 12]与 9%[SD 11]，P = 0.005）。住院医师也对进行 VH 更有信心（MI 组平均变化 19%[SD 16]，无 MI 组 11%[SD 10]，P = 0.033）。
MI 后住院医师的手术表现无差异。提高住院医师的自信心可能归因于 MI 或试验参与者的非盲效果。
