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在客观结构化临床考试中实施的基础腹腔镜泌尿科手术(BLUS(©))课程转移任务表现的决定因素。

Determinants of performance on the Transfer Task of the Basic Laparoscopic Urologic Surgery (BLUS(©)) curriculum administered at objective structured clinical examinations.

机构信息

Division of Urology, Department of Surgery, McGill University Health Center, McGill University, Montreal, Canada.

出版信息

J Endourol. 2013 Sep;27(9):1148-53. doi: 10.1089/end.2013.0065. Epub 2013 Jun 20.

Abstract

PURPOSE

To assess determinants of performance on the Transfer Task of the Basic Laparoscopic Urologic Surgery (BLUS(©)) skills curriculum administered at Objective Structured Clinical Examinations (OSCEs).

METHODS

After obtaining Institutional Review Board approval and informed consent, urology trainees (Postgraduate Year [PGY]-3 to PGY-5) from four different training programs (A, B, C, D) were recruited for the study. Transfer Task Times (TTTs) were compared and correlated with previous laparoscopic experience, amount of endotrainer practice and scores obtained at practice sessions and other OSCE stations.

RESULTS

A total of 37 trainees were evaluated on three successive semiannual OSCEs from May 2011 to May 2012, including 16 (43.2%) trainees from program A with a dedicated laparoscopic skills training program. Compared with trainees from programs B, C, and D, trainees from program A had significantly more practice per week (0 v 45 minutes, p=0.001) and significantly lower median TTTs at OSCEs (114 [68-209] v 74 [52-189] seconds, p=0.001) despite significantly lower number of laparoscopic cases assisted within the previous 6 months (13 [0-57] v 2 [0-35], p=0.001). For program A trainees, TTTs moderately correlated with median TTTs at practice sessions (r=0.57, p=0.001) and negatively correlated with amount of practice per week (r=-0.41, p=0.003). Thus, more training resulted in faster times at OSCEs. On multivariate analysis, amount of practice per week was the only significant predictor of TTTs at OSCEs (p=0.028).

CONCLUSION

Performance on the transfer task of BLUS during OSCEs significantly correlated with the amount of practice rather than the number of laparoscopic cases assisted.

摘要

目的

评估在客观结构化临床考试(OSCE)中进行的基本腹腔镜泌尿科手术(BLUS(©))技能课程转移任务中的表现的决定因素。

方法

在获得机构审查委员会批准和知情同意后,从四个不同培训计划(A、B、C、D)招募泌尿科学员(第 3 至第 5 年住院医师)参加研究。比较转移任务时间(TTT),并与之前的腹腔镜经验、内窥镜练习量以及实践课程和其他 OSCE 站的得分相关联。

结果

共有 37 名学员在 2011 年 5 月至 2012 年 5 月的三个连续半年度 OSCE 中进行了评估,其中 16 名(43.2%)学员来自有专门腹腔镜技能培训计划的计划 A。与计划 B、C 和 D 的学员相比,计划 A 的学员每周的练习量明显更多(0 分钟与 45 分钟,p=0.001),并且在 OSCE 中的中位 TTT 明显更短(114 [68-209] 秒与 74 [52-189] 秒,p=0.001),尽管在过去 6 个月内辅助的腹腔镜例数明显较少(13 [0-57] 与 2 [0-35],p=0.001)。对于计划 A 的学员,TTT 与实践课程中的中位数 TTT 中度相关(r=0.57,p=0.001),与每周练习量呈负相关(r=-0.41,p=0.003)。因此,更多的培训导致 OSCE 中更快的时间。在多变量分析中,每周的练习量是 OSCE 中 TTT 的唯一显著预测因素(p=0.028)。

结论

在 OSCE 中,BLUS 的转移任务表现与练习量显著相关,而与辅助的腹腔镜例数无关。

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