Marlow Nicholas, Altree Meryl, Babidge Wendy, Field John, Hewett Peter, Maddern Guy J
Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.
ANZ J Surg. 2014 Dec;84(12):976-80. doi: 10.1111/ans.12282. Epub 2013 Jun 19.
Training in basic laparoscopic skills can be undertaken using traditional methods, where trainees are educated by experienced surgeons through a process of graduated responsibility or by simulation-based training. This study aimed to assess whether simulation trained individuals reach the same level of proficiency in basic laparoscopic skills as traditional trained participants when assessed in a simulated environment.
A prospective study was undertaken. Participants were allocated to one of two cohorts according to surgical experience. Participants from the inexperienced cohort were randomized to receive training in basic laparoscopic skills on either a box trainer or a virtual reality simulator. They were then assessed on the simulator on which they did not receive training. Participants from the experienced cohort, considered to have received traditional training in basic laparoscopic skills, did not receive simulation training and were randomized to either the box trainer or virtual reality simulator for skills assessment. The assessment scores from different cohorts on either simulator were then compared.
A total of 138 participants completed the assessment session, 101 in the inexperienced simulation-trained cohort and 37 on the experienced traditionally trained cohort. There was no statistically significant difference between the training outcomes of simulation and traditionally trained participants, irrespective of the simulator type used.
The results demonstrated that participants trained on either a box trainer or virtual reality simulator achieved a level of basic laparoscopic skills assessed in a simulated environment that was not significantly different from participants who had been traditionally trained in basic laparoscopic skills.
基础腹腔镜技能培训可采用传统方法,即由经验丰富的外科医生通过逐步增加责任的过程对学员进行培训,或采用基于模拟的培训。本研究旨在评估在模拟环境中进行评估时,接受模拟培训的个体在基础腹腔镜技能方面是否能达到与接受传统培训的参与者相同的熟练程度。
进行了一项前瞻性研究。根据手术经验将参与者分配到两个队列之一。来自无经验队列的参与者被随机分配接受箱式训练器或虚拟现实模拟器上的基础腹腔镜技能培训。然后在他们未接受培训的模拟器上对他们进行评估。来自有经验队列的参与者,被认为接受过基础腹腔镜技能的传统培训,未接受模拟培训,并被随机分配到箱式训练器或虚拟现实模拟器进行技能评估。然后比较不同队列在任一模拟器上的评估分数。
共有138名参与者完成了评估环节,101名在无经验的模拟培训队列中,37名在有经验的传统培训队列中。无论使用何种模拟器类型,模拟培训和传统培训参与者的培训结果之间均无统计学显著差异。
结果表明,在箱式训练器或虚拟现实模拟器上接受培训的参与者在模拟环境中所达到的基础腹腔镜技能水平,与接受过基础腹腔镜技能传统培训的参与者相比无显著差异。