Department of Surgery, University of Nevada School of Medicine, Las Vegas, NV, USA.
J Reconstr Microsurg. 2012 Oct;28(8):539-42. doi: 10.1055/s-0032-1315774. Epub 2012 Jun 28.
Medical training is increasingly focused on patient safety, limiting the ability to practice technical skills in the operative arena. Alternative methods of training residents must be designed and implemented.
Three expert microsurgeons were solicited to develop two drills to help residents acquire the basic subset of skills in microsurgery. The first drill was performance of five consecutive simple interrupted sutures on a rubber glove. Expert proficiency was considered a drill time of two standard deviations from expert mean. The drill was performed up to 10 times until completion of the task at expert proficiency. The second drill was performance of an anastomosis on silastic tubing. Residents performed the drill sequentially until performing two consecutive drills at expert proficiency.
Eight residents with no microsurgical experience volunteered. Six of the eight residents were able to perform the rubber glove drill at expert proficiency within 10 attempts, with an average of 5.3. All of the residents were able to perform two consecutive silastic tubing drills at expert proficiency within nine attempts, with an average of 5.4.
Residents were able to acquire a basic subset of microsurgical skills within a reasonable time period using these drills.
医学培训越来越注重患者安全，这限制了在手术领域练习技术技能的能力。必须设计和实施替代的住院医师培训方法。
三位专家显微外科医生被邀请开发两项训练，以帮助住院医师获得显微外科基本技能集。第一项训练是在橡胶手套上连续进行五次简单间断缝合。专家熟练度被认为是从专家平均值两个标准差的训练时间。这项训练最多可以进行 10 次，直到达到专家熟练程度完成任务。第二项训练是在硅橡胶管上进行吻合。住院医师依次进行训练，直到达到专家熟练程度完成两个连续训练。
有 8 名没有显微外科经验的住院医师自愿参加。在 10 次尝试中，有 6 名住院医师能够达到专家熟练程度完成橡胶手套训练，平均用时 5.3。所有住院医师都能够在 9 次尝试内达到专家熟练程度完成两个连续的硅橡胶管训练，平均用时 5.4。
住院医师在合理的时间内使用这些训练能够获得基本的显微外科技能。
