Kemp Bohan Phillip M, Connelly Christopher R, Crawford Jeff, Bronson Nathan W, Schreiber Martin A, Lucius Chris W, Hunter John G, Kiraly Laszlo N, Ham Bruce
Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA; Oregon Health & Science University, Department of Surgery, Portland, OR, USA.
Oregon Health & Science University, Department of Surgery, Portland, OR, USA.
Am J Surg. 2017 May;213(5):888-894. doi: 10.1016/j.amjsurg.2017.03.011. Epub 2017 Mar 23.
We developed a laparoscopic common bile duct exploration (LCBDE) simulation course for resident surgeons (RS) and practicing surgeons (PS). We hypothesized that course completion would provide LCBDE procedural skills and increase procedure utilization.
RS and PS were prospectively enrolled. Pre- and post-course ability were assessed with written examinations and LCBDE simulations. PS completed pre-course, post-course, and 1-year follow-up surveys (5-point Likert-type scale).
17 RS and 8 PS were enrolled. Median written test scores improved (70.0%-80.0%, p < 0.001) and median LCBDE simulation times (seconds) improved (585-314, p = 0.001) among all participants. Comparing RS and PS, median written assessment scores pre-course (70% vs 72.5%, p = 0.953) and post-course (77.5% vs 80.0%, p = 0.198) were not significantly different. Simulation completion times (seconds) improved similarly from pre-course (608.0 vs 521.5, p = 0.885) to post-course (314.0 vs 373.0, p = 0.287) between groups. PS comfort with LCBDE improved (2-4, p = 0.03). All PS reported LCBDE utilization 1 year post-course.
The LCBDE course is appropriate for RS and PS. PS also reported increased comfort with LCBDE and procedure utilization.
我们为住院医师（RS）和执业医师（PS）开发了一种腹腔镜胆总管探查术（LCBDE）模拟课程。我们假设完成该课程将提供LCBDE操作技能并提高该手术的使用率。
前瞻性招募RS和PS。通过笔试和LCBDE模拟评估课程前后的能力。PS完成课程前、课程后和1年随访调查（5点李克特量表）。
共招募了17名RS和8名PS。所有参与者的笔试中位数成绩有所提高（70.0% - 80.0%，p < 0.001），LCBDE模拟时间中位数（秒）也有所改善（585 - 314，p = 0.001）。比较RS和PS，课程前笔试中位数成绩（70%对72.5%，p = 0.953）和课程后（77.5%对80.0%，p = 0.198）无显著差异。两组之间模拟完成时间（秒）从课程前（608.0对521.5，p = 0.885）到课程后（314.0对373.0，p = 0.287）的改善情况相似。PS对LCBDE的操作舒适度有所提高（2 - 4，p = 0.03）。所有PS均报告在课程后1年使用了LCBDE。
LCBDE课程适用于RS和PS。PS也报告称对LCBDE的操作舒适度和手术使用率有所提高。
