Department of Surgical Training, Royal College of Surgeons in Ireland.
Simul Healthc. 2012 Oct;7(5):274-81. doi: 10.1097/SIH.0b013e31825b6308.
The purpose of this study was to explore whether basic endovascular skills acquired using proficiency-based simulation training in superficial femoral artery (SFA) angioplasty translate to real-world performance.
Five international experts were invited to evaluate a preliminary 28-item rating scale for SFA angioplasty using a modified Delphi study. To test the procedural scale, 4 experts and 11 final-year medical students then performed 2 SFA angioplasties each on the vascular intervention simulation trainer simulator. Thereafter, 10 general surgical residents (novices) received didactic training in SFA angioplasty. Trainees were then randomized with 5 trainees receiving further training on the vascular intervention simulation trainer simulator up to proficiency level. All 10 trainees then performed 1 SFA angioplasty on a patient within 5 days of training. The trainees' performance was assessed by 1 attending consultant blinded to the trainees' training status, using the developed procedural scale and a global rating scale.
Four items were eliminated from the procedural scale after the Delphi study. There were significant differences in the procedural scale scores between the experts and the students in the first trial [mean (SD), 94.25 (2.22) vs. 74.90 (8.79), P = 0.001] and the second trial [95.25 (0.50) vs. 76.82 (9.44), P < 0.001]. Simulation-trained trainees scored higher than the controls on the procedural scale [86.8 (5.4) vs. 67.6 (6), P = 0.001] and the global rating scale [37.2 (4.1) vs. 24.4 (5.3), P = 0.003].
Basic endovascular skills acquired using proficiency-based simulation training in SFA angioplasty do translate to real-world performance.
本研究旨在探讨在股浅动脉（SFA）血管成形术中使用基于熟练度的模拟培训获得的基本腔内技能是否能转化为实际操作。
邀请了 5 名国际专家使用改良 Delphi 研究对 SFA 血管成形术的初步 28 项评分量表进行评估。为了测试程序量表，4 名专家和 11 名医学专业最后一年的学生随后在血管介入模拟训练器模拟器上各自进行了 2 次 SFA 血管成形术。此后，10 名普通外科住院医师（新手）接受了 SFA 血管成形术的理论培训。然后，将受训者随机分为 5 组，其中 5 名受训者在血管介入模拟训练器模拟器上接受进一步的培训，直至达到熟练水平。所有 10 名受训者在培训后 5 天内在患者身上进行了 1 次 SFA 血管成形术。培训者的表现由 1 位主治顾问进行评估，该顾问对培训者的培训情况不知情，使用开发的程序量表和总体评分量表进行评估。
在 Delphi 研究后，程序量表中有 4 项被删除。在第一次试验中，专家和学生在程序量表得分上存在显著差异[平均值（标准差），94.25（2.22）与 74.90（8.79），P=0.001]和第二次试验[95.25（0.50）与 76.82（9.44），P < 0.001]。经过模拟培训的受训者在程序量表[86.8（5.4）与 67.6（6），P=0.001]和总体评分量表[37.2（4.1）与 24.4（5.3），P=0.003]上的得分均高于对照组。
在股浅动脉血管成形术中使用基于熟练度的模拟培训获得的基本腔内技能确实可以转化为实际操作。
