Christy Jonathan M, Kolovich Gregory P, Beal Matthew D, Mayerson Joel L
Arthur James Cancer Hospital, Ohio State University, Columbus, OH.
Am J Orthop (Belle Mead NJ). 2014 Nov;43(11):E246-52; quiz E253-4.
The most effective way to teach and assess a resident's knowledge of musculoskeletal medicine, including orthopedic-specific surgical skills, remains unclear. We designed a surgical skills training session to educate junior-level orthopedic residents in 4 core areas: comfort with basic power equipment, casting/splinting, suturing, and surgical instrument identification. As part of the study reported here, 11 orthopedic residents (postgraduate year 1-3) completed a skills session and were evaluated with written examinations and an ankle fracture model before and after the session. Four other junior residents were unable to attend the session because of clinical responsibilities. For the group of 11 residents who completed the written examination, mean (SD) presession percentile was 87.3 (10.4), mean (SD) postsession percentile was 92 (8.4), median was 96, and mode was 96. There was a significant pre-post difference among all test takers, regardless of training level (P < .05). In the ankle fracture model, for the entire group, mean (SD) overall presession percentile was 68.6 (13.9), and mean (SD) overall postsession percentile was 95.2 (5.2). There was a significant pre-post difference among all test takers, regardless of training level (P = .03). An intensive laboratory has the potential to improve junior-level residents' basic surgical skills and knowledge.
目前尚不清楚教授和评估住院医师肌肉骨骼医学知识（包括骨科特定手术技能）的最有效方法。我们设计了一个手术技能培训课程，对初级骨科住院医师进行四个核心领域的培训：熟悉基本动力设备、石膏固定/夹板固定、缝合以及手术器械识别。作为本文所报告研究的一部分，11名骨科住院医师（研究生一年级至三年级）完成了技能培训课程，并在课程前后通过笔试和踝关节骨折模型进行了评估。另外四名初级住院医师因临床职责未能参加该课程。对于完成笔试的11名住院医师群体，课前百分位数均值（标准差）为87.3（10.4），课后百分位数均值（标准差）为92（8.4），中位数为96，众数为96。所有考生课前和课后存在显著差异，无论培训水平如何（P <.05）。在踝关节骨折模型中，对于整个群体，课前总体百分位数均值（标准差）为68.6（13.9），课后总体百分位数均值（标准差）为95.2（5.2）。所有考生课前和课后存在显著差异，无论培训水平如何（P =.03）。强化实验室有潜力提高初级住院医师的基本手术技能和知识。
