Colaco Henry B, Hughes Katie, Pearse Eyiyemi, Arnander Magnus, Tennent Duncan
St George's University of London, London, United Kingdom.
St George's University of London, London, United Kingdom.
J Surg Educ. 2017 Jan-Feb;74(1):47-54. doi: 10.1016/j.jsurg.2016.07.006. Epub 2016 Oct 5.
We have developed a low-cost, portable shoulder simulator designed to train basic arthroscopic skills. This study aimed to establish the construct validity of the simulator by determining which parameters discriminated between experience levels and to assess the experience of using the simulator.
Participants were given an introductory presentation and an untimed practice run of a 6-step triangulation task using hooks and rubber bands. A total of 6 consecutive attempts at the task were timed, and the number of times the participant looked at their hands during the task was recorded. Participants then completed a questionnaire on their experience of using the simulator.
St George's Hospital, London and the South West London Elective Orthopaedic Centre, Surrey.
Medical students, trainee doctors and surgeons, and consultant surgeons were approached to use the simulator. Participation was voluntary and nonincentivized. In total, 7 orthopedic consultants, 12 trainee doctors (ranging from foundation year 1 to clinical fellow post-Certificate of Completion of Training), and 9 medical students were recruited.
The average time for medical students to complete the task was 161 seconds, compared to 118 seconds for trainees, and 84 seconds for consultants. The average fastest time for medical students was 105 seconds, 73 seconds for trainees, and 52 seconds for consultants. Students were significantly slower than trainees (p = 0.026) and consultants (p = 0.001). However, times did not differ significantly between trainees and consultants. Consultants looked at their hands 0.7 times on average during the task compared with 2.8 and 3.4 times for trainees and students, respectively. More than 95% of participants found the exercise interesting and agreed or strongly agreed that the simulator was easy to use, easily portable, and well designed and constructed.
This study has established construct validity of the simulator by demonstrating the ability to distinguish between surgical experience levels. The learning curve shows improvement in individuals with or without arthroscopic or surgical experience. Simulation is becoming increasingly important in the training of medical students and surgical trainees; this study has established that low-cost portable arthroscopic box trainers may play a significant role.
我们研发了一种低成本、便携式肩部模拟器，旨在训练基本的关节镜手术技能。本研究旨在通过确定哪些参数能够区分不同经验水平来建立模拟器的结构效度，并评估使用该模拟器的体验。
参与者先接受了一次介绍性讲解，并进行了一次使用钩子和橡皮筋的6步三角测量任务的无时间限制练习。对该任务连续进行6次尝试并计时，记录参与者在任务过程中看手的次数。参与者随后完成了一份关于使用模拟器体验的问卷。
伦敦圣乔治医院和萨里郡西南伦敦择期骨科中心。
邀请了医学生、实习医生和外科医生以及顾问外科医生使用该模拟器。参与是自愿的且无激励措施。总共招募了7名骨科顾问、12名实习医生（从第1年基础培训到完成培训证书后的临床研究员）和9名医学生。
医学生完成任务的平均时间为161秒，实习生为118秒，顾问为84秒。医学生的平均最快时间为105秒，实习生为73秒，顾问为52秒。学生明显比实习生（p = 0.026）和顾问（p = 0.001）慢。然而，实习生和顾问之间的时间没有显著差异。顾问在任务过程中平均看手0.7次，实习生和学生分别为2.8次和3.4次。超过95%的参与者认为该练习有趣，并同意或强烈同意该模拟器易于使用、便于携带且设计精良。
本研究通过证明能够区分手术经验水平，建立了模拟器的结构效度。学习曲线表明，无论有无关节镜或手术经验，个体都有进步。模拟在医学生和外科实习生的培训中变得越来越重要；本研究表明低成本便携式关节镜训练箱可能发挥重要作用。
