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为血管外科实习生开设的强化血管外科技能与模拟课程可提高程序知识和自我评估的程序能力。

An intensive vascular surgical skills and simulation course for vascular trainees improves procedural knowledge and self-rated procedural competence.

作者信息

Robinson William P, Doucet Danielle R, Simons Jessica P, Wyman Allison, Aiello Francesco A, Arous Elias, Schanzer Andres, Messina Louis M

机构信息

Division of Vascular and Endovascular Surgery, University of Virginia School of Medicine, Charlottesville, Va.

Division of Vascular and Endovascular Surgery, University of Massachusetts Memorial Medical Center, University of Massachusetts Medical School, Worcester, Mass.

出版信息

J Vasc Surg. 2017 Mar;65(3):907-915.e3. doi: 10.1016/j.jvs.2016.12.065.

Abstract

BACKGROUND

Surgical skills and simulation courses are emerging to meet the demand for vascular simulation training for vascular surgical skills, but their educational effect has not yet been described. We sought to determine the effect of an intensive vascular surgical skills and simulation course on the procedural knowledge and self-rated procedural competence of vascular trainees and to assess participant feedback regarding the course.

METHODS

Participants underwent a 1.5-day course covering open and endovascular procedures on high-fidelity simulators and cadavers. Before and after the course, participants completed a written test that assessed procedural knowledge concerning index open vascular and endovascular procedures. Participants also assessed their own procedural competence in open and endovascular procedures on a 5-point Likert scale (1: no ability to perform, 5: performs independently). Scores before and after the course were compared among postgraduate year (PGY) 1-2 and PGY 3-7 trainees. Participants completed a survey to rate the relevance and realism of open and endovascular simulations.

RESULTS

Fifty-eight vascular integrated residents and vascular fellows (PGY 1-7) completed the course and all assessments. After course participation, procedural knowledge scores were significantly improved among PGY 1-2 residents (50% correct before vs 59% after; P < .0001) and PGY 3-7 residents (52% correct before vs 63% after; P = .003). Self-rated procedural competence was significantly improved among PGY 1-2 (2.2 ± 0.1 before vs 3.1 ± 0.1 after; P < .0001) and PGY 3-7 (3.0 ± 0.1 before vs 3.7 ± 0.1 after; P ≤ .0001). Self-rated procedural competence significantly improved for both endovascular (2.4 ± 0.1 before vs 3.3 ± 0.1 after; P < .0001) and open procedures (2.7 ± 0.1 before vs 3.5 ± 0.1 after; P < .0001). More than 93% of participants reported they were "satisfied" or "very satisfied" with the relevance and realism of the open and endovascular simulations. All participants reported they would recommend the course to other trainees.

CONCLUSIONS

This intensive vascular surgical skills and simulation course improved procedural knowledge concerning index open vascular and endovascular procedures among PGY 1-2 and PGY 3-7 trainees. The course also improved self-rated procedural competence across all levels of training for open and endovascular procedures. Trainees rated the value of a surgical skills and simulation course highly. These results support strong consideration for the implementation of similar intensive simulation and surgical skills courses with ongoing objective assessment of their educational effect.

摘要

背景

为满足血管外科手术技能的血管模拟训练需求,外科手术技能和模拟课程不断涌现,但其教育效果尚未得到描述。我们试图确定强化血管外科手术技能和模拟课程对血管实习生的程序知识和自我评估的程序能力的影响,并评估参与者对该课程的反馈。

方法

参与者参加了为期1.5天的课程,内容涵盖在高保真模拟器和尸体上进行开放手术和血管腔内手术。在课程前后,参与者完成了一项书面测试,评估有关索引开放血管和血管腔内手术的程序知识。参与者还使用5分李克特量表(1:无执行能力,5:独立执行)评估自己在开放手术和血管腔内手术中的程序能力。比较了1-2年级住院医师(PGY)和3-7年级住院医师课程前后的分数。参与者完成了一项调查,以评估开放手术和血管腔内模拟的相关性和逼真度。

结果

58名血管综合住院医师和血管专科住院医师(PGY 1-7)完成了课程及所有评估。参加课程后,1-2年级住院医师的程序知识得分显著提高(之前为50%正确,之后为59%;P <.0001),3-7年级住院医师的得分也显著提高(之前为52%正确,之后为63%;P =.003)。1-2年级住院医师自我评估的程序能力显著提高(之前为2.2±0.1,之后为3.1±0.1;P <.0001),3-7年级住院医师也是如此(之前为3.0±0.1,之后为3.7±0.1;P≤.0001)。血管腔内手术(之前为2.4±0.1,之后为3.3±0.1;P <.0001)和开放手术(之前为2.7±0.1,之后为3.5±0.1;P <.0001)的自我评估程序能力均显著提高。超过93%的参与者报告他们对开放手术和血管腔内模拟的相关性和逼真度“满意”或“非常满意”。所有参与者都表示会向其他实习生推荐该课程。

结论

这一强化血管外科手术技能和模拟课程提高了1-2年级和3-7年级住院医师关于索引开放血管和血管腔内手术的程序知识。该课程还提高了所有培训水平的开放手术和血管腔内手术的自我评估程序能力。实习生对手术技能和模拟课程的价值评价很高。这些结果支持大力考虑实施类似的强化模拟和手术技能课程,并持续对其教育效果进行客观评估。

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