Hong Paul, Webb Amanda N, Corsten Gerard, Balderston Janet, Haworth Rebecca, Ritchie Krista, Massoud Emad
IWK Health Centre, Department of Surgery, Halifax, NS, Canada; Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada B3J 3G9.
IWK Health Centre, Department of Surgery, Halifax, NS, Canada.
Int J Pediatr Otorhinolaryngol. 2014 Mar;78(3):522-9. doi: 10.1016/j.ijporl.2013.12.036. Epub 2014 Jan 10.
Myringotomy and tympanostomy tube insertion (MT) is a common surgical procedure. Although surgical simulation has proven to be an effective training tool, an anatomically sound simulation model for MT is lacking. We developed such a model and assessed its impact on the operating room performance of senior medical students.
Prospective randomized trial.
A randomized single-blind controlled study of simulation training with the MT model versus no simulation training. Each participant was randomized to either the simulation model group or control group, after performing an initial MT procedure. Within two weeks of the first procedure, the students performed a second MT. All procedures were performed on real patients and rated with a Global Rating Scale by two attending otolaryngologists. Time to complete the MT was also recorded.
Twenty-four senior medical students were enrolled. Control and intervention groups did not differ at baseline on their Global Rating Scale score or time to complete the MT procedure. Following simulation training, the study group received significantly higher scores (P=.005) and performed the MT procedure in significantly less time (P=.034). The control group did not improve their performance scores (P>.05) or the time to complete the procedure (P>.05).
Our surgical simulation model shows promise for being a valuable teaching tool for MT for senior medical students. Such anatomically appropriate physical simulators may benefit teaching of junior trainees.
鼓膜切开置管术（MT）是一种常见的外科手术。尽管手术模拟已被证明是一种有效的培训工具，但缺乏用于MT的解剖结构合理的模拟模型。我们开发了这样一种模型，并评估了其对高年级医学生手术室操作表现的影响。
前瞻性随机试验。
一项关于使用MT模型进行模拟训练与不进行模拟训练的随机单盲对照研究。在进行首次MT手术后，将每位参与者随机分为模拟模型组或对照组。在第一次手术后的两周内，学生们进行第二次MT。所有手术均在真实患者身上进行，并由两名耳鼻喉科主治医生使用整体评分量表进行评分。还记录了完成MT的时间。
招募了24名高年级医学生。对照组和干预组在基线时的整体评分量表得分或完成MT手术的时间方面没有差异。经过模拟训练后，研究组获得了显著更高的分数（P = 0.005），并且完成MT手术的时间显著缩短（P = 0.034）。对照组的表现分数（P>0.05）或完成手术的时间（P>0.05）没有改善。
我们的手术模拟模型有望成为高年级医学生MT的有价值的教学工具。这种解剖结构合适的物理模拟器可能有益于低年级学员的教学。
