Centre for Surgical Technologies, K.U.LEUVEN, Leuven, Belgium; Department of Urology, University Hospitals K.U.LEUVEN, Leuven, Belgium; Department of Urology, University Hospital Antwerp, Antwerp, Belgium.
J Surg Educ. 2013 Sep-Oct;70(5):596-605. doi: 10.1016/j.jsurg.2013.04.001. Epub 2013 Jun 10.
To investigate whether preclinical laparoscopy training offers a benefit over standard apprenticeship training and apprenticeship training in combination with simulation training.
This randomized controlled trial consisted of 3 groups of first-year surgical registrars receiving a different teaching method in laparoscopic surgery.
The KU LEUVEN Faculty of Medicine is the largest medical faculty in Belgium.
Thirty final-year medical students starting a general surgical career in the next academic year.
Thirty final-year medical students were randomized into 3 groups, which differed in the way they were exposed to laparoscopic simulation training but were comparable in regard to ambidexterity, sex, age, and laparoscopic psychomotoric skills. The control group received only clinical training during surgical residentship, whereas the interval group received clinical training in combination with simulation training. The registrars were allowed to do deliberate practice. The Centre for Surgical Technologies Preclinical Training Programme (CST PTP) group received a preclinical simulation course during the final year as medical students, but was not exposed to any extra simulation training during surgical residentship. At the beginning of surgical residentship and 6 months later, all subjects performed a standardized suturing task and a laparoscopic cholecystectomy in a POP Trainer. All procedures were recorded together with time and motion tracking parameters. All videos were scored by a blinded observer using global rating scales.
At baseline the 3 groups were comparable. At 6 months, for suturing, the CST PTP group was better than both the other groups with respect to time, checklist, and amount of movements. The interval group was better than the control group on only the time and checklist score. For the cholecystectomy evaluation, there was a statistical difference between the CST PTP study group and both other groups on all evaluation scales in favor of the CST PTP group.
Structured, preclinical proficiency-based training is better than clinical training combined with laboratory training or clinical training alone.
研究在腹腔镜手术中，临床前腹腔镜培训是否优于标准学徒制培训以及学徒制培训与模拟培训相结合。
这是一项随机对照试验，包括 3 组接受不同腹腔镜手术教学方法的一年级外科住院医师。
KU LEUVEN 医学系是比利时最大的医学系。
30 名即将在未来学术年度开始普通外科生涯的最后一年医学生。
30 名最后一年的医学生被随机分为 3 组，他们接受腹腔镜模拟培训的方式不同，但在双手灵巧性、性别、年龄和腹腔镜心理运动技能方面具有可比性。对照组仅在外科住院医师期间接受临床培训，而间隔组则接受临床培训与模拟培训相结合。住院医师可以进行刻意练习。CST PTP 组的住院医师在最后一年作为医学生接受了临床前模拟课程，但在外科住院医师期间没有接受任何额外的模拟培训。在外科住院医师开始时和 6 个月后，所有受试者都在 POP 训练器中进行了标准化缝合任务和腹腔镜胆囊切除术。所有程序都与时间和运动跟踪参数一起记录。所有视频均由盲法观察者使用整体评分量表进行评分。
基线时，3 组具有可比性。在 6 个月时，对于缝合，CST PTP 组在时间、检查表和动作数量方面均优于其他两组。间隔组仅在时间和检查表评分方面优于对照组。对于胆囊切除术评估，CST PTP 研究组与其他两组在所有评估量表上均存在统计学差异，CST PTP 组更具优势。
基于技能的结构化临床前培训优于临床培训与实验室培训相结合或单独的临床培训。
