Schwab Ben, Hungness Eric, Barsness Katherine Ann, McGaghie William Craig
1 Department of Surgery, Northwestern University Feinberg School of Medicine , Chicago, Illinois.
2 Division of Pediatric Surgery, Ann and Robert H Lurie Children's Hospital of Chicago , Chicago, Illinois.
J Laparoendosc Adv Surg Tech A. 2017 May;27(5):450-454. doi: 10.1089/lap.2016.0644. Epub 2017 Jan 24.
The current healthcare environment demands optimization of patient outcomes in addition to maximal cost efficiency. Restrictions on resident work hours have placed limitations on the amount of time that trainee physicians can spend on patient care. For the surgery resident, the consequence is less time spent in the operating room under the supervision of a senior surgeon, the cornerstone of Halsted's approach to resident surgeon education. The use of simulation in graduate medical education has gained significant traction as a way to provide trainees with exposure to various techniques and procedures before use on the general patient population. This article describes simulation-based education with particular attention to surgical education. It proceeds to address competency-based education and mastery learning (ML) as key features of effective surgery education programs. A case study of ML in surgery is presented along with examples of translational medical education science from other medical specialties. The report concludes with a brief discussion about simulation-based surgical education today and prospects for the future.
当前的医疗环境要求在实现成本效率最大化的同时，优化患者治疗效果。对住院医师工作时长的限制，制约了实习医生用于患者护理的时间。对于外科住院医师而言，其结果是在资深外科医生监督下在手术室度过的时间减少，而这曾是霍尔斯特德培养住院外科医生方法的基石。模拟技术在毕业后医学教育中的应用，作为一种在将各种技术和程序应用于普通患者群体之前让实习生接触它们的方式，已经获得了广泛关注。本文介绍基于模拟的教育，尤其关注外科教育。接着探讨基于胜任力的教育和掌握学习（ML），将其作为有效外科教育项目的关键特征。呈现了一个外科领域掌握学习的案例研究，以及来自其他医学专业的转化医学教育科学实例。报告最后简要讨论了当今基于模拟的外科教育情况以及未来前景。
