Walters Christen L, Whitworth Jenny M, Tyra Sharon L, Walsh-Covarrubias Julie B, Straughn J Michael
J Grad Med Educ. 2013 Jun;5(2):320-2. doi: 10.4300/JGME-D-12-00061.1.
Duty hour restrictions and enhanced focus on patient safety have prompted the development of new instruction models for practice of surgical techniques outside the operating room, including models for teaching loop electrosurgical excisional procedure (LEEP), a common procedure that gynecology residents perform to diagnose and manage cervical disease.
We sought to develop an inexpensive and reusable training model for guided practice opportunities that will improve gynecology residents' LEEP technique.
Polyvinyl chloride, foam, and a polish sausage are used to simulate the basic anatomy of the vagina and cervix. A 2-in-diameter polyvinyl chloride pipe and high-density foam are used to create a realistic representation with the sausage simulating the cervix. An electrosurgical pad is attached to the sausage and a standard operating room electrosurgical generator is used.
After a brief lecture and demonstration of the LEEP procedure, gynecology residents are positioned at individual stations. Use of 2 to 3 instructors allows for the provision of directions and feedback to residents as they perform the simulated LEEP. During the last 6 years, this model has continued to improve residents' confidence and skills with the procedure.
An anatomically accurate LEEP model can not only improve resident knowledge, skills, and confidence, but also improve quality and patient safety. This training model allows residents to refine their surgical skills through guided practice and instructors to monitor performance before residents to perform the procedure on patients.
工作时间限制以及对患者安全的日益关注促使人们开发了新的指导模式,用于在手术室之外进行外科技术操作的实践,包括用于指导环形电切术(LEEP)操作的模式,LEEP是妇科住院医师用于诊断和治疗宫颈疾病的常见操作。
我们试图开发一种价格低廉且可重复使用的培训模型,用于提供有指导的实践机会,以提高妇科住院医师的LEEP技术。
使用聚氯乙烯、泡沫和一根波兰香肠来模拟阴道和宫颈的基本解剖结构。用一根直径2英寸的聚氯乙烯管和高密度泡沫制作出逼真的模型,香肠模拟宫颈。在香肠上连接一个电外科极板,并使用标准的手术室电外科发生器。
在对LEEP操作进行简短的讲座和演示后,将妇科住院医师安排在各个操作台前。安排2至3名指导教师,以便在住院医师进行模拟LEEP操作时为他们提供指导和反馈。在过去6年中,该模型持续提高了住院医师对该操作的信心和技能。
一个解剖结构准确的LEEP模型不仅可以提高住院医师的知识、技能和信心,还可以提高医疗质量和患者安全。这种培训模型使住院医师能够通过有指导的实践来完善他们的手术技能,并使指导教师能够在住院医师对患者进行该操作之前监测其操作表现。