Dessolle Lionel, Leperlier Florence, Biau David J, Fréour Thomas, Barrière Paul
Service de Biologie et Médecine de la Reproduction, Centre Hospitalier Universitaire de Nantes, 38, Bd Jean Monnet, 44093 Nantes Cedex 1, France.
Service de Biologie et Médecine de la Reproduction, Centre Hospitalier Universitaire de Nantes, 38, Bd Jean Monnet, 44093 Nantes Cedex 1, France.
Reprod Biomed Online. 2014 Aug;29(2):187-92. doi: 10.1016/j.rbmo.2014.03.016. Epub 2014 Apr 18.
The number of procedures required for a trainee to reach proficiency in oocyte retrieval and the criteria applied to define performance are not well defined. To evaluate the learning curve of oocyte retrieval, this study prospectively evaluated three trainees over 6 months. Oocyte retrieval was monitored by the learning curve-cumulative summation test (LC-CUSUM), a specific statistical tool designed to indicate when a predefined level of performance is reached. Oocytes were retrieved from one ovary by the trainee and from the second ovary by a senior operator in a randomized manner. The main outcome measure was the ratio of oocytes collected and follicles aspirated. A trainee's ratio of ≥ 80% of the senior operator's defined success. From 17 to >50 procedures were necessary for the trainees to reach the predefined level of performance. Cumulative summation tests implemented after the learning phase confirmed that performance was maintained. The present study confirms the large variability in acquiring proficiency for surgical procedures. It provides an exportable model for a quantitative tailored monitoring of the learning curve and for continuous monitoring of performance in oocyte retrieval.
对于一名实习生而言，达到熟练进行卵母细胞采集所需的操作次数以及用于定义操作表现的标准尚无明确界定。为评估卵母细胞采集的学习曲线，本研究对三名实习生进行了为期6个月的前瞻性评估。通过学习曲线累积和检验（LC-CUSUM）对卵母细胞采集进行监测，这是一种专门设计的统计工具，用于表明何时达到预先定义的操作表现水平。实习生从一侧卵巢采集卵母细胞，高级操作员从另一侧卵巢以随机方式采集卵母细胞。主要观察指标是采集的卵母细胞与抽吸的卵泡的比例。实习生达到高级操作员定义的成功比例≥80%。实习生需要进行17至50多次操作才能达到预先定义的操作表现水平。学习阶段后实施的累积和检验证实操作表现得以维持。本研究证实了在掌握手术操作熟练程度方面存在很大差异。它为定量定制监测学习曲线以及持续监测卵母细胞采集的操作表现提供了一个可推广的模型。
