Research, Audit, and Academic Surgery Division, Royal Australasian College of Surgeons, 199 Ward Street, North Adelaide, SA, Australia.
Surg Endosc. 2013 Jul;27(7):2606-12. doi: 10.1007/s00464-013-2798-6. Epub 2013 Feb 7.
Laparoscopic skills development via simulation-based medical education programs has gained support in recent years. However, the impact of training site type on skills acquisition has not been examined. The objective of this research was to determine whether laparoscopic skills training outcomes differ as a result of training in a Mobile Simulation Unit (MSU) compared with fixed simulation laboratories.
An MSU was developed to provide delivery of training. Fixed-site and MSU laparoscopic skills training outcomes data were compared. Fixed-site participants from three Australian states were pooled to create a cohort of 144 participants, which was compared with a cohort derived from pooled MSU participants in one Australian state. Data were sourced from training periods held from October 2009 to December 2010. LapSim and Fundamentals of laparoscopic surgery (FLS) simulators were used at the MSU and fixed sites. Participants self-reported on demographic and experience variables. They trained to a level of competence on one simulator and were assessed on the other simulator, thus producing crossover scores. No participants trained at both site types.
When FLS-trained participants were assessed on LapSim, those who received MSU training achieved a significantly higher crossover score than their fixed-site counterparts (p < 0.001). Compared with baseline data, MSU LapSim-trained participants assessed on FLS displayed a performance increase of 23.1 %, whereas MSU FLS-trained participants assessed on LapSim demonstrated a 12.4 % increase in performance skills. Participants at fixed sites displayed performance increases of 5.2 and 10.9 %, respectively.
Mobile Simulation Unit-delivered laparoscopic simulation training is not inferior to fixed-site training.
近年来,基于模拟的医学教育计划在腹腔镜技能发展方面得到了支持。然而,培训地点类型对技能获取的影响尚未得到检验。本研究的目的是确定在移动模拟单元(MSU)中进行腹腔镜技能培训与在固定模拟实验室中进行培训的结果是否存在差异。
开发了一个 MSU 来提供培训。比较了固定地点和 MSU 腹腔镜技能培训结果的数据。将来自澳大利亚三个州的固定地点参与者进行汇总,创建了一个 144 名参与者的队列,该队列与来自澳大利亚一个州的 MSU 参与者汇总的队列进行了比较。数据来源于 2009 年 10 月至 2010 年 12 月期间的培训期。MSU 和固定地点都使用了 LapSim 和腹腔镜手术基础(FLS)模拟器。参与者报告了人口统计学和经验变量。他们在一个模拟器上进行了熟练程度的培训,然后在另一个模拟器上进行了评估,从而产生了交叉评分。没有参与者在两种地点类型上都接受过培训。
当接受过 FLS 培训的参与者在 LapSim 上进行评估时,接受 MSU 培训的参与者的交叉评分显著高于固定地点的参与者(p<0.001)。与基线数据相比,在 FLS 上接受 MSU LapSim 培训的参与者的表现提高了 23.1%,而在 LapSim 上接受 MSU FLS 培训的参与者的表现技能提高了 12.4%。在固定地点的参与者的表现分别提高了 5.2%和 10.9%。
MSU 提供的腹腔镜模拟培训并不逊于固定地点的培训。