Schoeff Stephen, Hernandez Brian, Robinson Derek J, Jameson Mark J, Shonka David C
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia, U.S.A.
Laryngoscope. 2017 Nov;127(11):2490-2494. doi: 10.1002/lary.26586. Epub 2017 Apr 13.
OBJECTIVES/HYPOTHESIS: To compare the effectiveness of massed versus interval training when teaching otolaryngology residents microvascular suturing on a validated microsurgical model.
Otolaryngology residents were placed into interval (n = 7) or massed (n = 7) training groups. The interval group performed three separate 30-minute practice sessions separated by at least 1 week, and the massed group performed a single 90-minute practice session. Both groups viewed a video demonstration and recorded a pretest prior to the first training session. A post-test was administered following the last practice session.
At an academic medical center, 14 otolaryngology residents were assigned using stratified randomization to interval or massed training. Blinded evaluators graded performance using a validated microvascular Objective Structured Assessment of Technical Skill tool. The tool is comprised of two major components: task-specific score (TSS) and global rating scale (GRS). Participants also received pre- and poststudy surveys to compare subjective confidence in multiple aspects of microvascular skill acquisition.
Overall, all residents showed increased TSS and GRS on post- versus pretest. After completion of training, the interval group had a statistically significant increase in both TSS and GRS, whereas the massed group's increase was not significant. Residents in both groups reported significantly increased levels of confidence after completion of the study.
Self-directed learning using a chicken thigh artery model may benefit microsurgical skills, competence, and confidence for resident surgeons. Interval training results in significant improvement in early development of microvascular anastomosis skills, whereas massed training does not.
NA. Laryngoscope, 127:2490-2494, 2017.
目的/假设：在一个经过验证的显微外科模型上教授耳鼻咽喉科住院医师微血管缝合技术时，比较集中训练与间隔训练的效果。
将耳鼻咽喉科住院医师分为间隔训练组（n = 7）和集中训练组（n = 7）。间隔训练组进行三次单独的30分钟练习课程，每次课程间隔至少1周，集中训练组进行一次90分钟的练习课程。两组在第一次训练课程前观看视频演示并进行预测试。在最后一次练习课程后进行后测试。
在一所学术医疗中心，使用分层随机化将14名耳鼻咽喉科住院医师分配到间隔训练组或集中训练组。盲法评估者使用经过验证的微血管技术客观结构化评估工具对表现进行评分。该工具由两个主要部分组成：特定任务得分（TSS）和整体评分量表（GRS）。参与者还接受了研究前和研究后的调查，以比较微血管技能获取多个方面的主观信心。
总体而言，所有住院医师在后测试中的TSS和GRS均高于预测试。训练完成后，间隔训练组的TSS和GRS均有统计学意义的增加，而集中训练组的增加不显著。两组住院医师在研究完成后报告信心水平均显著提高。
使用鸡大腿动脉模型进行自主学习可能有助于住院外科医生提高显微外科技能、能力和信心。间隔训练在微血管吻合技能的早期发展中带来显著改善，而集中训练则不然。
无。《喉镜》，2017年，第127卷，第2490 - 2494页。
