Lin Diwei, Pena Guilherme, Field John, Altree Meryl, Marlow Nicholas, Babidge Wendy, Hewett Peter, Maddern Guy
The Queen Elizabeth Hospital, University of Adelaide Discipline of Surgery, Adelaide, South Australia, Australia.
Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Adelaide, South Australia, Australia.
ANZ J Surg. 2016 Dec;86(12):983-989. doi: 10.1111/ans.12992. Epub 2015 Feb 2.
Simulation is playing an increasingly important role in surgical education. There are a number of laparoscopic simulators of which the design and tasks vary considerably. It is unknown if any particular type may result in better outcomes for a specific population. This study assesses the predictors of acquisition of basic surgical skills on two different laparoscopic simulators.
Participants (n = 370) were randomized to be trained and assessed using either a fundamentals of laparoscopic surgery (FLS) or a LapSim (Surgical Science, Goteborg, Sweden) simulator. The number of attempts required to reach proficiency on individual tasks and on each simulator was recorded and compared with demographic data and surgical experience.
Skills acquisition on both simulators was positively affected by surgical experience. Gender was an influential factor on the LapSim with men reaching proficiency sooner than women. The effect of gaming had no clear influence on the participants' scores; however, for those who reported more than 1 h/week gaming, it had a positive influence on skills acquisition on the FLS and a negative influence on the LapSim. Playing a musical instrument had no impact. Practising non-surgical tasks requiring manual dexterity and handedness were not an influential factor in total proficient scores, but had a significant impact on individual task scores on the FLS simulator.
The rate of skills acquisition on each simulator and individual tasks are influenced by different demographic characteristics of the participants. This has implications for surgical education as it may inform the selection of the most suitable laparoscopic simulators for specific populations of trainees.
模拟在外科手术教育中发挥着越来越重要的作用。有多种腹腔镜模拟器，其设计和任务差异很大。尚不清楚任何特定类型的模拟器是否会为特定人群带来更好的学习效果。本研究评估了在两种不同的腹腔镜模拟器上获得基本手术技能的预测因素。
参与者（n = 370）被随机分配使用腹腔镜手术基础（FLS）模拟器或LapSim（瑞典哥德堡外科科学公司）模拟器进行培训和评估。记录在各个任务以及每个模拟器上达到熟练水平所需的尝试次数，并将其与人口统计学数据和手术经验进行比较。
手术经验对两种模拟器上技能的获得均有积极影响。性别是LapSim模拟器上的一个影响因素，男性比女性更快达到熟练水平。游戏对参与者的分数没有明显影响；然而，对于那些报告每周游戏时间超过1小时的人来说，游戏对FLS模拟器上的技能获得有积极影响，而对LapSim模拟器有负面影响。演奏乐器没有影响。练习需要手巧和用手习惯的非手术任务在总体熟练分数中不是一个影响因素，但对FLS模拟器上的单个任务分数有显著影响。
每个模拟器和单个任务上技能获得的速度受参与者不同人口统计学特征的影响。这对外科手术教育有启示意义，因为它可能有助于为特定学员群体选择最合适的腹腔镜模拟器。
