Aydin Abdullatif, Muir Gordon H, Graziano Manuela E, Khan Muhammad Shamim, Dasgupta Prokar, Ahmed Kamran
MRC Centre for Transplantation, King's College London and Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, King's College Hospital, London, UK.
Department of Urology, King's College Hospital, London, UK.
BJU Int. 2015 Jun;115(6):994-1003. doi: 10.1111/bju.12842. Epub 2014 Dec 7.
To assess face, content and construct validity, and feasibility and acceptability of the GreenLight™ Simulator as a training tool for photoselective vaporisation of the prostate (PVP), and to establish learning curves and develop an evidence-based training curriculum.
This prospective, observational and comparative study, recruited novice (25 participants), intermediate (14) and expert-level urologists (seven) from the UK and Europe at the 28th European Association of Urological Surgeons Annual Meeting 2013. A group of novices (12 participants) performed 10 sessions of subtask training modules followed by a long operative case, whereas a second group (13) performed five sessions of a given case module. Intermediate and expert groups performed all training modules once, followed by one operative case. The outcome measures for learning curves and construct validity were time to task, coagulation time, vaporisation time, average sweep speed, average laser distance, blood loss, operative errors, and instrument cost. Face and content validity, feasibility and acceptability were addressed through a quantitative survey.
Construct validity was demonstrated in two of five training modules (P = 0.038; P = 0.018) and in a considerable number of case metrics (P = 0.034). Learning curves were seen in all five training modules (P < 0.001) and significant reduction in case operative time (P < 0.001) and error (P = 0.017) were seen. An evidence-based training curriculum, to help trainees acquire transferable skills, was produced using the results.
This study has shown the GreenLight Simulator to be a valid and useful training tool for PVP. It is hoped that by using the training curriculum for the GreenLight Simulator, novice trainees can acquire skills and knowledge to a predetermined level of proficiency.
评估GreenLight™模拟器作为前列腺光选择性汽化术（PVP）训练工具的表面效度、内容效度和结构效度，以及可行性和可接受性，并建立学习曲线和制定基于证据的培训课程。
这项前瞻性、观察性和对比性研究，于2013年第28届欧洲泌尿外科学会年会上，从英国和欧洲招募了新手（25名参与者）、中级（14名）和专家级泌尿外科医生（7名）。一组新手（12名参与者）进行10节子任务训练模块，随后进行一个长时间的手术病例，而另一组（13名）进行5节给定病例模块。中级和专家组各进行一次所有训练模块，随后进行一个手术病例。学习曲线和结构效度的结果指标包括任务时间、凝血时间、汽化时间、平均扫描速度、平均激光距离、失血量、手术失误和器械成本。通过定量调查评估表面效度和内容效度、可行性和可接受性。
在五个训练模块中的两个模块显示出结构效度（P = 0.038；P = 0.018），并且在相当数量的病例指标中也显示出结构效度（P = 0.034）。在所有五个训练模块中均观察到学习曲线（P < 0.001），并且病例手术时间（P < 0.001）和失误（P = 0.017）有显著减少。利用这些结果制定了一个基于证据的培训课程，以帮助学员获得可转移的技能。
本研究表明GreenLight模拟器是一种用于PVP的有效且有用的训练工具。希望通过使用GreenLight模拟器的培训课程，新手学员能够获得达到预定熟练水平的技能和知识。
