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使用模拟器评估兽医学生卵巢子宫切除术的手术技能准备情况:一项初步研究。

Evaluation of Veterinary Student Surgical Skills Preparation for Ovariohysterectomy Using Simulators: A Pilot Study.

作者信息

Read Emma K, Vallevand Andrea, Farrell Robin M

出版信息

J Vet Med Educ. 2016 Summer;43(2):190-213. doi: 10.3138/jvme.0815-138R1. Epub 2016 Apr 25.

Abstract

This paper describes the development and evaluation of training intended to enhance students' performance on their first live-animal ovariohysterectomy (OVH). Cognitive task analysis informed a seven-page lab manual, 30-minute video, and 46-item OVH checklist (categorized into nine surgery components and three phases of surgery). We compared two spay simulator models (higher-fidelity silicone versus lower-fidelity cloth and foam). Third-year veterinary students were randomly assigned to a training intervention: lab manual and video only; lab manual, video, and $675 silicone-based model; lab manual, video, and $64 cloth and foam model. We then assessed transfer of training to a live-animal OVH. Chi-square analyses determined statistically significant differences between the interventions on four of nine surgery components, all three phases of surgery, and overall score. Odds ratio analyses indicated that training with a spay model improved the odds of attaining an excellent or good rating on 25 of 46 checklist items, six of nine surgery components, all three phases of surgery, and the overall score. Odds ratio analyses comparing the spay models indicated an advantage for the $675 silicon-based model on only 6 of 46 checklist items, three of nine surgery components, and one phase of surgery. Training with a spay model improved performance when compared to training with a manual and video only. Results suggested that training with a lower-fidelity/cost model might be as effective when compared to a higher-fidelity/cost model. Further research is required to investigate simulator fidelity and costs on transfer of training to the operational environment.

摘要

本文描述了旨在提高学生首次活体动物卵巢子宫切除术(OVH)表现的培训的开发与评估。认知任务分析为一本七页的实验手册、一个30分钟的视频以及一份46项的OVH检查表(分为九个手术组成部分和三个手术阶段)提供了依据。我们比较了两种绝育模拟器模型(高保真硅胶模型与低保真布质和泡沫模型)。三年级兽医专业学生被随机分配到一种培训干预措施中:仅实验手册和视频;实验手册、视频以及价值675美元的硅胶模型;实验手册、视频以及价值64美元的布质和泡沫模型。然后,我们评估了培训向活体动物OVH的迁移效果。卡方分析确定了在九个手术组成部分中的四个、所有三个手术阶段以及总分方面,各干预措施之间存在统计学上的显著差异。优势比分析表明,使用绝育模型进行培训提高了在46项检查表项目中的25项、九个手术组成部分中的六项、所有三个手术阶段以及总分上获得优秀或良好评级的几率。比较绝育模型的优势比分析表明,价值675美元的硅胶模型仅在46项检查表项目中的6项、九个手术组成部分中的3项以及一个手术阶段上具有优势。与仅使用实验手册和视频进行培训相比,使用绝育模型进行培训可提高表现。结果表明,与高保真/高成本模型相比,使用低保真/低成本模型进行培训可能同样有效。需要进一步研究来调查模拟器保真度和成本对培训向操作环境迁移的影响。

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