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提高住院医师眼部整形手术的操作水平:一种使用手术湿实验室视频的新课程。

Improving Resident Performance in Oculoplastic Surgery: A New Curriculum Using Surgical Wet Laboratory Videos.

作者信息

Mishra Kapil, Mathai Mariam, Della Rocca Robert C, Reddy Harsha S

机构信息

Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York.

Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York.

出版信息

J Surg Educ. 2017 Sep-Oct;74(5):837-842. doi: 10.1016/j.jsurg.2017.02.009. Epub 2017 Mar 9.

Abstract

OBJECTIVE

To develop a new oculoplastic curriculum that incorporates learning theory of skill acquisition. To develop and evaluate the effectiveness of instructional videos for an oculoplastic surgical wet laboratory.

DESIGN

Proof of concept, randomized controlled trial.

SETTING

New York Eye and Ear Infirmary of Mount Sinai-tertiary care academic institution.

PARTICIPANTS AND METHODS

In total, 16 ophthalmology residents were randomly assigned to 1 of 2 groups and given either video and text or text instructions alone for the following 2 procedures: blepharoplasty and eyelid laceration repair. Operating time and esthetic result were measured, and the groups were statistically compared. A brief survey was administered.

RESULTS

We developed a new 6 component oculoplastics curriculum that incorporates concepts of the Fitts and Posner skill acquisition model and mental imagery. In the wet laboratory pilot study, the group that watched the video of the laceration repair showed better esthetic grades than the group that received text alone (p = 0.038). This difference was not found for the blepharoplasty (p = 0.492). There was no difference between groups in operating time for the laceration repair (p = 0.722), but the group that watched the blepharoplasty video required more time to complete the task than those that reviewed text only (p = 0.023). In total, 100% of residents reported the videos augmented their learning.

CONCLUSIONS

Methods to optimize surgical education are important given limited operating room time in oculoplastics, a subspecialty in which the number of surgeries performed during residency is relatively low. We developed a curriculum based on learning theory and sought to formally test one important aspect, surgical video for wet laboratories. Our pilot study, despite its limitations, showed that wet laboratory surgical videos can be effective tools in improving motor skill acquisition for oculoplastic surgery.

摘要

目的

开发一门融合技能习得学习理论的新型眼整形课程。开发并评估用于眼整形手术模拟实验室的教学视频的有效性。

设计

概念验证性随机对照试验。

地点

西奈山伊坎医学院附属纽约眼耳医院——三级医疗学术机构。

参与者与方法

总共16名眼科住院医师被随机分为两组,分别给予视频加文本或仅文本的指导,用于以下两种手术:眼睑成形术和眼睑裂伤修复术。测量手术时间和美学效果,并对两组进行统计学比较。进行了一项简短调查。

结果

我们开发了一门包含菲茨和波斯纳技能习得模型及心理意象概念的新型六部分眼整形课程。在模拟实验室初步研究中,观看裂伤修复视频的组比仅接受文本指导的组美学评分更高(p = 0.038)。眼睑成形术组未发现这种差异(p = 0.492)。裂伤修复手术的手术时间两组之间无差异(p = 0.722),但观看眼睑成形术视频的组完成任务所需时间比仅复习文本的组更多(p = 0.023)。总体而言,100%的住院医师报告视频增强了他们的学习效果。

结论

鉴于眼整形手术中手术室时间有限,而住院医师期间进行的手术数量相对较少,优化手术教育的方法很重要。我们基于学习理论开发了一门课程,并试图正式测试一个重要方面,即模拟实验室的手术视频。我们的初步研究尽管存在局限性,但表明模拟实验室手术视频可以成为提高眼整形手术运动技能习得的有效工具。

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