Thomas Geb W, Johns Brian D, Marsh J Lawrence, Anderson Donald D
Department of Mechanical and Industrial Engineering The University of Iowa.
Department of Orthopaedics and Rehabilitation The University of Iowa.
Iowa Orthop J. 2014;34:181-9.
Orthopaedic surgical skill is traditionally acquired during training in an apprenticeship model that has been largely unchanged for nearly 100 years. However, increased pressure for operating room efficiency, a focus on patient safety, work hour restrictions, and a movement towards competency-based education are changing the traditional paradigm. Surgical simulation has the potential to help address these changes. This manuscript reviews the scientific background on skill acquisition and surgical simulation as it applies to orthopaedic surgery. It argues that simulation in orthopaedics lags behind other disciplines and focuses too little on simulator validation. The case is made that orthopaedic training is more efficient with simulators that facilitate deliberate practice throughout resident training and more research should be focused on simulator validation and the refinement of skill definition.
传统上，骨科手术技能是在学徒模式的培训过程中习得的，这种模式在近100年里基本没有变化。然而，手术室效率压力的增加、对患者安全的关注、工作时间限制以及向基于能力的教育的转变正在改变传统模式。手术模拟有潜力帮助应对这些变化。本文回顾了适用于骨科手术的技能习得和手术模拟的科学背景。文中指出，骨科领域的模拟落后于其他学科，且对模拟器验证的关注过少。有理由认为，在住院医师培训期间，使用有助于刻意练习的模拟器进行骨科培训效率更高，并且应更多地关注模拟器验证和技能定义的完善。
