Enani Ghada, Watanabe Yusuke, McKendy Katherine M, Bilgic Elif, Feldman Liane S, Fried Gerald M, Vassiliou Melina C
Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
J Surg Educ. 2017 Jul-Aug;74(4):656-662. doi: 10.1016/j.jsurg.2016.12.004. Epub 2017 Apr 3.
Advanced laparoscopic suturing is considered a challenging skill to acquire. The aim of this study was to investigate the learning process for advanced laparoscopic suturing in the operating room to understand the obstacles trainees face when trying to master the skill.
A qualitative methodology using semistructured interviews and field observations was used. Data were analyzed using a Grounded Theory approach. Participants were general surgery residents and surgeons with advanced minimally invasive surgery (MIS) experience.
Ten MIS surgeons across different institutions and 15 local general surgery residents were interviewed. The semistructured interviews and field observations of 9 advanced MIS operations (27h) yielded the following 6 themes around the acquisition of laparoscopic suturing skills for residents: complexity, training misalignment, variability of opportunities, inconsistency of techniques, lack of feedback, and differing expectations.
There are several unmet training needs around laparoscopic suturing skills. Training for advanced laparoscopic skills requires more emphasis on coaching and the development of advanced models. This study heralded the need to incorporate advanced laparoscopic skills into the surgical simulation curriculum.
高级腹腔镜缝合技术被认为是一项难以掌握的技能。本研究的目的是调查在手术室中学习高级腹腔镜缝合技术的过程，以了解学员在试图掌握该技能时所面临的障碍。
采用半结构化访谈和实地观察的定性研究方法。使用扎根理论方法对数据进行分析。参与者为普通外科住院医师和具有高级微创手术（MIS）经验的外科医生。
对来自不同机构的10名MIS外科医生和15名当地普通外科住院医师进行了访谈。对9台高级MIS手术（27小时）的半结构化访谈和实地观察围绕住院医师腹腔镜缝合技能的掌握产生了以下6个主题：复杂性、培训不一致、机会的可变性、技术的不一致性、缺乏反馈以及期望不同。
腹腔镜缝合技能存在一些未满足的培训需求。高级腹腔镜技能的培训需要更多地强调指导和先进模型的开发。本研究预示着将高级腹腔镜技能纳入手术模拟课程的必要性。
