Molinas Carlos Roger, Campo Rudi
Neolife Medicina y Cirugía Reproductiva, Avenida Brasilia 760, 1434 Asunción, Paraguay ; European Academy of Gynaecological Surgery, Leuven, Belgium.
European Academy of Gynaecological Surgery, Leuven, Belgium.
Gynecol Surg. 2016;13(4):395-402. doi: 10.1007/s10397-016-0962-4. Epub 2016 Jul 16.
This follow-up RCT was conducted to evaluate laparoscopic psychomotor skills retention after finishing a structured training program. In a first study, 80 gynecologists were randomly allocated to four groups to follow different training programs for hand-eye coordination (task 1) with the dominant hand (task 1-a) and the non-dominant hand (task 1-b) and laparoscopic intra-corporeal knot tying (task 2) in the Laparoscopic Skills Testing and Training (LASTT) model. First, baseline skills were tested (T1). Then, participants trained task 1 (G1: 1-a and 1-b, G2: 1-a only, G3 and G4: none) and then task 2 (all groups but G4). After training all groups were tested again to evaluate skills acquisition (T2). For this study, 2 years after a resting period, 73 participants were recruited and tested again to evaluate skills retention (T3). All groups had comparable skills at T1 for all tasks. At T2, G1, G2, and G3 improved their skills, but the level of improvement was different (G1 = G2 > G3 > G4 for task 1; G1 = G2 = G3 > G4 for task 2). At T3, all groups retained their task 1 skills at the same level than at T2. For task 2, however, a skill decay was already noticed for G2 and G3, being G1 the only group that retained their skills at the post-training level. Training improves laparoscopic skills, which can be retained over time depending on the comprehensiveness of the training program and on the complexity of the task. For high complexity tasks, full training is advisable for both skills acquisition and retention.
这项随访随机对照试验旨在评估在完成一个结构化培训项目后腹腔镜操作技能的保持情况。在第一项研究中,80名妇科医生被随机分为四组,在腹腔镜技能测试与培训(LASTT)模型中,针对优势手(任务1-a)和非优势手(任务1-b)的手眼协调(任务1)以及腹腔镜体内打结(任务2)遵循不同的培训方案。首先,测试基线技能(T1)。然后,参与者训练任务1(G1组:1-a和1-b,G2组:仅1-a,G3组和G4组:不训练),接着训练任务2(除G4组外的所有组)。训练后对所有组再次进行测试以评估技能习得情况(T2)。在本研究中,休息2年后,招募了73名参与者并再次进行测试以评估技能保持情况(T3)。在T1时,所有组在所有任务上的技能水平相当。在T2时,G1组、G2组和G3组的技能有所提高,但提高程度不同(任务1:G1 = G2 > G3 > G4;任务2:G1 = G2 = G3 > G4)。在T3时,所有组在任务1上保持了与T2时相同的技能水平。然而,对于任务2,G2组和G3组已经出现技能衰退,G1组是唯一在训练后水平保持技能的组。培训可提高腹腔镜技能,技能能否长期保持取决于培训方案的全面性和任务的复杂性。对于高复杂性任务,为了技能习得和保持,建议进行全面培训。