Department of Surgery, University of Toronto, Toronto, Canada.
J Am Coll Surg. 2012 Oct;215(4):580-586.e3. doi: 10.1016/j.jamcollsurg.2012.05.035. Epub 2012 Jul 3.
Simulation-based training can improve technical and nontechnical skills in surgery. To date, there is no consensus on the principles for design, validation, and implementation of a simulation-based surgical training curriculum. The aim of this study was to define such principles and formulate them into an interoperable framework using international expert consensus based on the Delphi method.
Literature was reviewed, 4 international experts were queried, and consensus conference of national and international members of surgical societies was held to identify the items for the Delphi survey. Forty-five international experts in surgical education were invited to complete the online survey by ranking each item on a Likert scale from 1 to 5. Consensus was predefined as Cronbach's α ≥0.80. Items that 80% of experts ranked as ≥4 were included in the final framework.
Twenty-four international experts with training in general surgery (n = 11), orthopaedic surgery (n = 2), obstetrics and gynecology (n = 3), urology (n = 1), plastic surgery (n = 1), pediatric surgery (n = 1), otolaryngology (n = 1), vascular surgery (n = 1), military (n = 1), and doctorate-level educators (n = 2) completed the iterative online Delphi survey. Consensus among participants was achieved after one round of the survey (Cronbach's α = 0.91). The final framework included predevelopment analysis; cognitive, psychomotor, and team-based training; curriculum validation evaluation and improvement; and maintenance of training.
The Delphi methodology allowed for determination of international expert consensus on the principles for design, validation, and implementation of a simulation-based surgical training curriculum. These principles were formulated into a framework that can be used internationally across surgical specialties as a step-by-step guide for the development and validation of future simulation-based training curricula.
基于模拟的培训可以提高手术中的技术和非技术技能。迄今为止，对于基于模拟的手术培训课程的设计、验证和实施原则，尚无共识。本研究旨在通过基于 Delphi 方法的国际专家共识来定义这些原则，并将其制定为一个可互操作的框架。
文献回顾、查询 4 位国际专家，并召开全国和国际外科协会成员的共识会议，以确定 Delphi 调查的项目。邀请 45 名外科教育方面的国际专家通过对每个项目进行 1 到 5 的李克特量表排名来在线完成调查。共识定义为 Cronbach's α ≥0.80。80%的专家将≥4 的项目列入最终框架。
24 名具有普通外科（n = 11）、骨科（n = 2）、妇产科（n = 3）、泌尿科（n = 1）、整形外科（n = 1）、儿科外科（n = 1）、耳鼻喉科（n = 1）、血管外科（n = 1）、军事（n = 1）和博士级教育者（n = 2）培训背景的国际专家完成了迭代在线 Delphi 调查。一轮调查后达成了参与者之间的共识（Cronbach's α = 0.91）。最终框架包括前期开发分析；认知、心理运动和团队培训；课程验证评估和改进；以及培训维护。
Delphi 方法可确定设计、验证和实施基于模拟的手术培训课程的国际专家共识。这些原则被制定为一个框架，可以在国际上跨外科专业使用，作为未来基于模拟的培训课程的开发和验证的分步指南。
