Liu James K C, Kshettry Varun R, Recinos Pablo F, Kamian Kambiz, Schlenk Richard P, Benzel Edward C
Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
J Neurosurg. 2015 Nov;123(5):1331-8. doi: 10.3171/2014.11.JNS14902. Epub 2015 May 26.
Surgical education has been forced to evolve from the principles of its initial inception, in part due to external pressures brought about through changes in modern health care. Despite these pressures that can limit the surgical training experience, training programs are being held to higher standards of education to demonstrate and document trainee competency through core competencies and milestones. One of the methods used to augment the surgical training experience and to demonstrate trainee proficiency in technical skills is through a surgical skills laboratory. The authors have established a surgical skills laboratory by acquiring equipment and funding from nondepartmental resources, through institutional and private educational grants, along with product donations from industry. A separate educational curriculum for junior- and senior-level residents was devised and incorporated into the neurosurgical residency curriculum. The initial dissection curriculum focused on cranial approaches, with spine and peripheral nerve approaches added in subsequent years. The dissections were scheduled to maximize the use of cadaveric specimens, experimenting with techniques to best preserve the tissue for repeated uses. A survey of residents who participated in at least 1 year of the curriculum indicated that participation in the surgical skills laboratory translated into improved understanding of anatomical relationships and the development of technical skills that can be applied in the operating room. In addition to supplementing the technical training of surgical residents, a surgical skills laboratory with a dissection curriculum may be able to help provide uniformity of education across different neurosurgical training programs, as well as provide a tool to assess the progression of skills in surgical trainees.
外科教育已被迫从其最初设立的原则演变而来,部分原因是现代医疗保健变革带来的外部压力。尽管这些压力可能会限制外科培训经历,但培训项目正被要求达到更高的教育标准,以便通过核心能力和里程碑来展示和记录学员的能力。用于增强外科培训经历并展示学员技术技能熟练程度的方法之一是通过外科技能实验室。作者通过从非部门资源获取设备和资金、通过机构和私人教育赠款以及行业产品捐赠,建立了一个外科技能实验室。为初级和高级住院医师设计了单独的教育课程,并将其纳入神经外科住院医师课程。最初的解剖课程侧重于颅脑入路,随后几年增加了脊柱和周围神经入路。解剖安排旨在最大限度地利用尸体标本,并试验最佳保存组织以供重复使用的技术。对参加该课程至少一年的住院医师进行的一项调查表明,参与外科技能实验室能提高对解剖关系的理解,并培养可应用于手术室的技术技能。除了补充外科住院医师的技术培训外,一个设有解剖课程的外科技能实验室或许能够帮助在不同的神经外科培训项目中实现教育的一致性,还能提供一个评估外科受训人员技能进展的工具。