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目标设定可提高手术技能:一项随机对照试验。

Goal setting results in improvement in surgical skills: A randomized controlled trial.

作者信息

Kishiki Tomokazu, Lapin Brittany, Tanaka Ryota, Francis Taylor, Hughes Kathryn, Carbray JoAnn, Ujiki Michael B

机构信息

Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston, IL; Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan.

Department of Surgery, Section of Minimally Invasive Surgery, NorthShore University HealthSystem, Evanston, IL.

出版信息

Surgery. 2016 Oct;160(4):1028-1037. doi: 10.1016/j.surg.2016.07.022. Epub 2016 Aug 13.

Abstract

BACKGROUND

The objective of this randomized controlled trial was to determine whether a goal-setting program integrated into a surgical training curriculum would improve performance on simulation testing times and confidence with laparoscopic operative skills.

METHODS

Beginning in 2013, 36 students and 26 general surgery residents were randomized separately into 3 groups. Trainees were either given no time goals for each of 5 Fundamentals of Laparoscopic Surgery (FLS) tasks or were given time goals that were the mean time scores or the best time scores reported in the literature for passing each FLS task. All trainees were evaluated for each task with time scores and a confidence survey both prior to and after the training program.

RESULTS

For the students, all confidence scores and task times improved significantly from pre- to post-training. The average percent improvement in task times was greater for all 5 tasks in the 2 groups assigned to the goals compared to the no-goals group with the combined 5-task, mean percent improvement (P = .02). Overall, the students assigned to the mean-goal group improved more than the best or no-goal groups (P = .048). In the residents assigned to goals, all task times improved significantly pre/post, although the overall average percent improvement between groups was not different. Residents in both the no-goals and the goals groups improved their confidence with skills pre- to post-training.

CONCLUSION

The addition of achievable goals, defined as the average task time for residents who passed the FLS, was beneficial to students, because by achieving these goals, the students were able to achieve faster task times with improved confidence. Setting appropriate goals may improve laparoscopic operative skills in students. Suitable goals were also shown to strengthen accuracy and confidence in residents' laparoscopic operative skills.

摘要

背景

这项随机对照试验的目的是确定纳入外科培训课程的目标设定计划是否会提高模拟测试成绩以及腹腔镜手术技能的信心。

方法

从2013年开始,36名学生和26名普通外科住院医师分别随机分为3组。对于五项腹腔镜手术基础(FLS)任务中的每一项,受训者要么没有设定时间目标,要么设定的时间目标是文献中报道的通过每项FLS任务的平均时间得分或最佳时间得分。在培训计划前后,对所有受训者的每项任务进行时间得分评估和信心调查。

结果

对于学生而言,从培训前到培训后,所有信心得分和任务时间均有显著改善。与无目标组相比,分配到目标组的两组在所有5项任务中的平均任务时间改善百分比更高,五项任务综合平均改善百分比(P = 0.02)。总体而言,分配到平均目标组的学生比最佳目标组或无目标组改善得更多(P = 0.048)。在分配到目标组的住院医师中,所有任务时间在培训前后均有显著改善,尽管组间总体平均改善百分比没有差异。无目标组和目标组的住院医师在培训前后对技能的信心均有所提高。

结论

设定可实现的目标(定义为通过FLS的住院医师的平均任务时间)对学生有益,因为通过实现这些目标,学生能够以更高的信心更快地完成任务。设定适当的目标可能会提高学生的腹腔镜手术技能。合适的目标还被证明能增强住院医师腹腔镜手术技能的准确性和信心。

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