Department of Obstetrics and Gynecology, Juliane Marie Center, Center for Children, Women and Reproduction, Rigshospitalet University Hospital, Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 2014 Apr;93(4):359-66. doi: 10.1111/aogs.12330. Epub 2014 Jan 24.
The objective of this study was to develop a four-step curriculum in basic laparoscopy consisting of validated modules integrating a cognitive component, a practical component and a procedural component.
A four-step curriculum was developed. The methodology was different for each step. Step 1: A 1-day course in basic laparoscopy developed on the background of a regional needs analysis. Step 2: A multiple-choice test, developed and validated through interviews with experts in laparoscopy and subsequently through a Delphi audit involving regional chief physicians. Step 3: A procedural training task (a salpingectomy) on a validated virtual reality simulator. Step 4: An operation on a patient (a salpingectomy) with following formative assessment based on a validated assessment scale.
University hospital, Copenhagen, Denmark.
Fifty-two first-year residents in obstetrics and gynecology from 2009 to 2011.
Observational cohort study.
Completion rate.
All participants completed step 1 and improved post-course test scores compared with pre-course test scores, p = 0.001. Step 2 was completed by 75% (37/52); all improved test scores after 6 months, p = 0.001. Step 3 was completed by 75%. Participants used 238 min (range 75-599) and 38 repetitions (range 8-99) to reach proficiency level on a virtual reality simulator. Step 4 was completed by 55%. There was no correlation between test scores and simulator training time. Protected training time was correlated with increasing completion rate.
A four-step curriculum in basic laparoscopy is applicable in residency training. Protected training time correlated with increasing completion rate.
本研究旨在开发一个由四步课程组成的基础腹腔镜课程，其中包含经过验证的模块，整合了认知、实践和操作成分。
开发了一个四步课程。每一步的方法都不同。第 1 步：在区域需求分析的基础上，开展为期 1 天的基础腹腔镜课程。第 2 步：通过对腹腔镜专家进行访谈并随后通过涉及区域首席医师的 Delphi 审核，开发和验证了多项选择题测试。第 3 步：在经过验证的虚拟现实模拟器上进行操作训练任务（输卵管切除术）。第 4 步：对患者（输卵管切除术）进行手术，并根据经过验证的评估量表进行形成性评估。
丹麦哥本哈根大学医院。
2009 年至 2011 年期间的 52 名妇产科第一年住院医师。
观察性队列研究。
完成率。
所有参与者都完成了第 1 步，且与课程前测试相比，课程后测试成绩有所提高，p=0.001。第 2 步完成率为 75%（37/52）；所有人的测试成绩在 6 个月后都有所提高，p=0.001。第 3 步完成率为 75%。参与者使用 238 分钟（范围 75-599 分钟）和 38 次重复（范围 8-99 次）在虚拟现实模拟器上达到熟练水平。第 4 步完成率为 55%。测试成绩与模拟器训练时间之间没有相关性。受保护的训练时间与完成率的增加呈正相关。
基础腹腔镜四步课程适用于住院医师培训。受保护的训练时间与完成率的增加呈正相关。
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