van Rijssen L Bengt, van Empel Pieter J, Huirne Judith A, Bonjer H Jaap, Cuesta Miguel A, Meijerink W J H Jeroen
VU Medisch Centrum, Amsterdam, Afd. Heelkunde, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(26):A4036.
To investigate the additional value of the Advanced Suturing Course (ASC) in the basic laparoscopic skills training curriculum for residents.
Prospective cohort study.
Laparoscopic skills of 162 participants attending one of 17 ASCs held during the period April 2008-December 2010, were assessed before and after the training. Subjective and objective evaluation was performed using the Objective Structured Assessment of Technical Skills (OSATS) list and Motion Analysis Parameters (MAPs), recorded with the Training in Endoscopy tracking system, respectively. Confidence of participants in various laparoscopic tasks was rated using a visual analogue scale.
At the end of the first course day, mean OSATS-scores were significantly higher for open and laparoscopic knot-tying tasks than before the first course day. After 6 weeks of autonomous training, these scores were unaltered. Right hand MAPs were also unaltered after this training period. Confidence of participants in completing an open or a laparoscopic knot increased significantly during the entire course, as well as confidence in completing an open or laparoscopic intestinal anastomosis.
Medical simulation-based skills training appears to be an efficient method to improve certain basic laparoscopic skills in a relatively short period. Regular practice, sufficient opportunities for evaluation and feedback, and skills assessment are hereby critical.
探讨高级缝合课程（ASC）在住院医师腹腔镜基本技能培训课程中的附加价值。
前瞻性队列研究。
对2008年4月至2010年12月期间参加17个ASC之一的162名参与者的腹腔镜技能在培训前后进行评估。分别使用客观结构化技术技能评估（OSATS）清单和通过内镜培训跟踪系统记录的运动分析参数（MAPs）进行主观和客观评估。使用视觉模拟量表对参与者在各种腹腔镜任务中的信心进行评分。
在课程第一天结束时，开放和腹腔镜打结任务的平均OSATS分数显著高于课程第一天之前。经过6周的自主训练后，这些分数没有变化。在此训练期后右手MAPs也没有变化。在整个课程中，参与者完成开放或腹腔镜打结的信心显著增加，完成开放或腹腔镜肠吻合的信心也显著增加。
基于医学模拟的技能培训似乎是在相对较短时间内提高某些腹腔镜基本技能的有效方法。定期练习、充足的评估和反馈机会以及技能评估在此至关重要。
