De Win Gunter, Van Bruwaene Siska, Allen Christopher, De Ridder Dirk
Centre for Surgical Technologies, University Hospitals, KU Leuven, Leuven, Belgium ; Department of Urology, University Hospitals, KU Leuven, Leuven, Belgium.
Adv Med Educ Pract. 2013 May 9;4:103-15. doi: 10.2147/AMEP.S41681. Print 2013.
Surgical simulation is becoming increasingly important in surgical education. Despite the important work done on simulators, simulator model development, and simulator assessment methodologies, there is a need for development of integrated simulators in the curriculum. In this paper, we describe the design of our evidence-based preclinical training program for medical students applying for a surgical career at the Centre for Surgical Technologies.
Twenty-two students participated in this training program. During their final months as medical students, they received structured, proficiency-based endoscopy training. The total amount of mentored training was 18 hours and the training was organized into three training blocks. The first block focused on psychomotor training, the second block focused on laparoscopic stitching and suturing, and the third block on laparoscopic dissection techniques and hemostasis. Deliberate practice was allowed and students had to show proficiency before proceeding to the next training block. Students' psychomotor abilities were tested before the course and after each training block. At the beginning of their careers as surgical registrars, their performance on a laparoscopic suturing task was compared with that of registrars from the previous year who did not have this training course. Student opinions about this course were evaluated using a visual analog scale.
All students rated the training course as useful and their psychomotor abilities improved markedly. All students performed deliberate practice, and those who participated in this course scored significantly (P < 0.0001) better on the laparoscopic suturing task than first year registrars who did not participate in this course.
Organization of a structured preclinical training program in laparoscopy for final year medical students is feasible, attractive, and successful.
手术模拟在外科教育中变得越来越重要。尽管在模拟器、模拟器模型开发和模拟器评估方法方面已经开展了重要工作，但仍需要在课程中开发综合模拟器。在本文中，我们描述了为申请外科技术中心外科职业的医学生设计的循证临床前培训计划。
22名学生参加了该培训计划。在他们作为医学生的最后几个月里，他们接受了基于熟练程度的结构化内镜培训。指导培训的总时长为18小时，培训分为三个模块。第一个模块侧重于心理运动训练，第二个模块侧重于腹腔镜缝合，第三个模块侧重于腹腔镜解剖技术和止血。允许进行刻意练习，学生在进入下一个培训模块之前必须表现出熟练程度。在课程开始前以及每个培训模块结束后对学生的心理运动能力进行测试。在他们作为外科住院医师职业生涯开始时，将他们在腹腔镜缝合任务中的表现与上一年未参加该培训课程的住院医师进行比较。使用视觉模拟量表评估学生对该课程的意见。
所有学生都认为培训课程有用，并且他们的心理运动能力有了显著提高。所有学生都进行了刻意练习，参加该课程的学生在腹腔镜缝合任务中的得分明显（P < 0.0001）高于未参加该课程的一年级住院医师。
为医学最后一年的学生组织结构化的腹腔镜临床前培训计划是可行、有吸引力且成功的。
