Laski Dariusz, Stefaniak Tomasz J, Makarewicz Wojciech, Proczko Monika, Gruca Zbigniew, Sledziński Zbigniew
Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland.
Wideochir Inne Tech Maloinwazyjne. 2013 Sep;8(3):200-10. doi: 10.5114/wiitm.2011.33756. Epub 2013 Mar 6.
Surgical education has become one of the most important directions in modern surgery evolution. To meet growing need for appropriate training in laparoscopic and, even more importantly, classic surgical skills, a curriculum involving contemporary tuition methods is needed. Advanced, structuralised training, which includes advanced technologies like virtual reality training, video coaching and motivative aspects of competition, seems to be important for an adequate education programme.
In academic years 2009/2010 and 2010/2011 the Department of General, Endocrine and Transplant Surgery of the Medical University of Gdansk together with the Pomeranian Foundation for Progress in Surgery organized 4480 h of training in that area of classic (2744) and laparoscopic (1736) skills. Both groups were involved in the programme of training in which the two most important aspects were reliable evaluation of the results and effective motivation to work. Skill evaluation at different stages of the programme were based on completion time and quality measurements. Apart from that, at the end of the course, the participants completed a questionnaire on their subjective perspective on this innovative curriculum, the quality and stability of the skills they obtained.
In both arms of the programme (laparoscopic and classic) a statistically significant improvement was obtained as early as after the second and third sessions in half of the exercises. The acquired skills were stable over time, as proved by the plateau of completion time achieved in 11 out of 12 exercises. The results of the post-training questionnaire revealed that the participants were very satisfied with the structuralised form of training and appreciated the motivational role of competition.
Contemporary surgical training should be organized as a systematic, well-evaluated and goal-oriented programme similar to the one proposed by our team. The use of contemporary training aids should be utilized in training of every surgical skill, not only laparoscopy. This form of training, associated with the component of competition, enables good and stable results to be achieved, as well as high satisfaction of trainees.
外科教育已成为现代外科学发展的最重要方向之一。为满足对腹腔镜手术以及更重要的传统外科技能进行适当培训的不断增长的需求，需要一个涉及当代教学方法的课程。先进的结构化培训，包括虚拟现实培训、视频指导和竞争的激励因素等先进技术，对于一个适当的教育计划似乎很重要。
在2009/2010学年和2010/2011学年，格但斯克医科大学普通、内分泌与移植外科系与波美拉尼亚外科进步基金会共同组织了4480小时的传统（2744小时）和腹腔镜（1736小时）技能培训。两组都参与了培训计划，其中两个最重要的方面是对结果的可靠评估和有效的工作激励。在培训计划的不同阶段，技能评估基于完成时间和质量测量。除此之外，在课程结束时，参与者完成了一份关于他们对这一创新课程的主观看法、他们所获得技能的质量和稳定性的问卷。
在该计划的两个方面（腹腔镜和传统手术），早在第二次和第三次课程后，一半的练习就取得了统计学上显著的进步。所获得的技能随着时间的推移保持稳定，12项练习中有11项的完成时间达到了平稳状态，这证明了这一点。培训后问卷的结果显示，参与者对结构化的培训形式非常满意，并赞赏竞争的激励作用。
当代外科培训应像我们团队提出的那样，组织成一个系统的、经过充分评估且目标明确的计划。当代培训辅助工具应不仅用于腹腔镜手术，还应用于每一项外科技能的培训。这种与竞争元素相关的培训形式能够取得良好且稳定的结果，以及学员的高度满意度。
