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干模型下的离镜手术培训:西伯利亚经验。

Off-the-job microsurgical training on dry models: Siberian experience.

机构信息

Scientific Center of Reconstructive and Restorative Surgery, RAMS, Siberian Branch, Irkutsk, East Siberia, Russia.

Scientific Center of Reconstructive and Restorative Surgery, RAMS, Siberian Branch, Irkutsk, East Siberia, Russia; Department of Traumatology, Orthopedics and Neurosurgery, Irkutsk State Medical Academy of Continuous Education, Irkutsk, East Siberia, Russia; Department of Hospital Surgery and Neurosurgery, Irkutsk State Medical University, Irkutsk, East Siberia, Russia; Department of Neurosurgery, Irkutsk Rail Road Clinical Hospital, Irkutsk, East Siberia, Russia.

出版信息

World Neurosurg. 2014 Jul-Aug;82(1-2):20-4. doi: 10.1016/j.wneu.2014.01.018. Epub 2014 Feb 2.

Abstract

BACKGROUND

Microsurgical training has become an obligatory part of many neurosurgical training programs.

OBJECTIVE

To assess the cost and effectiveness of acquiring and maintaining microneurosurgical skills by training on an off-the-job basis using dry models.

METHODS

A dry off-the-job microneurosurgical training module was set up. Training exercises involved microdissection in a deep operation field, suturing and tying on gauze, untying, pushing of thread end, and microanastomosis. The time to complete the task and success rate were evaluated. The total cost of all necessary equipment and expendables for the training module was US$910.

RESULTS

Fifteen residents participated in the continuous off-the-job training. The average time taken to perform the anastomosis decreased after the month of training from 90 to 20 minutes. Authors revealed that at 2 months, the total time and time to complete anastomosis increased significantly for the participants who discontinued practice after the first month, compared with those who just practiced suturing on gauze after the first month (P < 0.01). The average Northwestern Objective Microanastomosis Assessment Tool score was 36 for novice and 65 for experienced participants.

CONCLUSION

The dry off-the-job training showed to be readily available and can be helpful for microsurgical training in the low-income regions of the world. Our data suggest that microsurgical training should be continuous and repetitive. Simulation training may benefit from models for repetitive training of relevant technical part-skills.

摘要

背景

显微外科训练已成为许多神经外科培训计划的必修部分。

目的

评估通过使用干模型进行在职外训练来获得和维持显微外科技能的成本和效果。

方法

建立了一个干的在职外显微外科训练模块。训练练习包括在深部手术场进行微解剖、在纱布上缝合和结扎、解开、推动线端以及微血管吻合。评估完成任务的时间和成功率。培训模块所需的所有设备和耗材的总成本为 910 美元。

结果

15 名住院医师参加了连续的在职外培训。经过一个月的训练,完成吻合术的平均时间从 90 分钟缩短到 20 分钟。作者发现,在两个月时,与仅在第一个月后在纱布上练习缝合的参与者相比,在第一个月后停止练习的参与者的总时间和完成吻合术的时间显著增加(P<0.01)。新手的西北客观显微吻合评估工具平均得分为 36,有经验的参与者得分为 65。

结论

干的在职外培训显示出易于获得,并且可以帮助世界上低收入地区的显微外科培训。我们的数据表明,显微外科培训应该是连续和重复的。模拟培训可能受益于重复训练相关技术部分技能的模型。

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