对现有泌尿外科技能培训课程及其验证情况的综述。

A review of the available urology skills training curricula and their validation.

作者信息

Shepherd William, Arora Karan Singh, Abboudi Hamid, Shamim Khan Mohammed, Dasgupta Prokar, Ahmed Kamran

机构信息

Department of Urology, MRC Centre for Transplantation, King's College London, Guy's Hospital, London, United Kingdom.

Department of Urology, Royal Sussex County Hospital, Brighton, United Kingdom.

出版信息

J Surg Educ. 2014 May-Jun;71(3):289-96. doi: 10.1016/j.jsurg.2013.09.005. Epub 2013 Dec 12.

Abstract

BACKGROUND

The transforming field of urological surgery continues to demand development of novel training devices and curricula for its trainees. Contemporary trainees have to balance workplace demands while overcoming the cognitive barriers of acquiring skills in rapidly multiplying and advancing surgical techniques. This article provides a brief review of the process involved in developing a surgical curriculum and the current status of real and simulation-based curricula in the 4 subgroups of urological surgical practice: open, laparoscopic, endoscopic, and robotic.

METHODS

An informal literature review was conducted to provide a snapshot into the variety of simulation training tools available for technical and nontechnical urological surgical skills within all subgroups of urological surgery using the following keywords: "urology, surgery, training, curriculum, validation, non-technical skills, technical skills, LESS, robotic, laparoscopy, animal models." Validated training tools explored in research were tabulated and summarized.

RESULTS AND CONCLUSIONS

A total of 20 studies exploring validated training tools were identified. Huge variation was noticed in the types of validity sought by researchers and suboptimal incorporation of these tools into curricula was noted across the subgroups of urological surgery. The following key recommendations emerge from the review: adoption of simulation-based curricula in training; better integration of dedicated training time in simulated environments within a trainee's working hours; better incentivization for educators and assessors to improvise, research, and deliver teaching using the technologies available; and continued emphasis on developing nontechnical skills in tandem with technical operative skills.

摘要

背景

泌尿外科手术这一不断变革的领域持续需要为其学员开发新型培训设备和课程。当代学员必须在应对工作场所需求的同时,克服在迅速增加和不断发展的手术技术中获取技能的认知障碍。本文简要回顾了制定手术课程所涉及的过程以及泌尿外科手术实践4个亚组(开放手术、腹腔镜手术、内镜手术和机器人手术)中基于真实操作和模拟的课程的现状。

方法

进行了一次非正式文献综述,以简要介绍泌尿外科手术所有亚组中可用于泌尿外科手术技术和非技术技能的各种模拟培训工具,使用以下关键词:“泌尿外科、手术、培训、课程、验证、非技术技能、技术技能、LESS、机器人手术、腹腔镜检查、动物模型”。将研究中探索的经过验证的培训工具制成表格并进行总结。

结果与结论

共确定了20项探索经过验证的培训工具的研究。研究人员所寻求的效度类型存在巨大差异,并且在泌尿外科手术各亚组中,这些工具在课程中的整合效果欠佳。综述得出以下关键建议:在培训中采用基于模拟的课程;在学员工作时间内更好地将在模拟环境中的专门培训时间整合进去;更好地激励教育工作者和评估人员利用现有技术进行创新、研究和授课;并继续强调在培养技术操作技能的同时发展非技术技能。

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