Department of Otolaryngology-Head and Neck Surgery, Georgetown University Hospital, Washington, DC 20007, USA.
Laryngoscope. 2013 Apr;123(4):841-4. doi: 10.1002/lary.23849. Epub 2013 Jan 3.
OBJECTIVES/HYPOTHESIS: To evaluate a previously validated low-cost sinus surgery task trainer as a means of acquiring basic endoscopic sinus surgery skills and as an objective structured assessment of technical skills (OSATS) to determine procedural competency.
Prospective blinded study.
Medical students (N = 52) with no sinus surgery experience learned to perform nasal endoscopy and five specific sinus surgery tasks using the validated task trainer. Training included regimented expert instruction, peer instruction/observation, and experienced-based learning. Pre- and post-training video recordings of nasal endoscopy and five sinus surgery skills were obtained. Two blinded expert otolaryngologists compared pre- and post-training performance using a checklist and global rating scale.
Medical student post-training performance was significantly better than pre-training performance for each checklist item and global rating scale as calculated by paired t test (P < .001). Interrater reliability and internal consistency were confirmed by Kendall's coefficient of concordance and Cronbach's α calculations, respectively.
The sinus surgery task trainer provides an effective means of teaching and evaluating nasal endoscopy and basic sinus surgery skills for novice surgeons. With repeated practice, there was significant improvement in performance. An OSATS using the sinus surgery task trainer suggests that we can effectively measure endoscopic sinus surgery ability with the potential to reliably determine competency outside the operating room.
目的/假设:评估一种经过验证的低成本鼻窦手术训练器,作为获得基本内窥镜鼻窦手术技能的方法,并作为客观结构化评估技术技能(OSATS)的方法,以确定手术能力。
前瞻性盲法研究。
没有鼻窦手术经验的医学生(N=52)使用经过验证的训练器学习进行鼻内窥镜检查和五项特定的鼻窦手术任务。培训包括有规定的专家指导、同伴指导/观察和基于经验的学习。在鼻内窥镜检查和五项鼻窦手术技能的培训前后都获得了视频记录。两位盲法耳鼻喉科专家使用检查表和总体评分量表比较培训前后的表现。
通过配对 t 检验(P<0.001),医学生的培训后表现明显优于培训前的表现,每个检查表项目和总体评分量表都是如此。Kendall 协和系数和 Cronbach's α 计算分别确认了评分者间可靠性和内部一致性。
鼻窦手术训练器为新手外科医生提供了一种教授和评估鼻内窥镜检查和基本鼻窦手术技能的有效方法。经过反复练习,手术表现有了显著的提高。使用鼻窦手术训练器的 OSATS 表明,我们可以有效地测量内窥镜鼻窦手术能力,并有可能在手术室外可靠地确定手术能力。