Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Department of General Surgery, University of Calgary, Calgary, Alberta, Canada.
J Surg Educ. 2017 Nov-Dec;74(6):1028-1038. doi: 10.1016/j.jsurg.2017.05.018. Epub 2017 Jun 7.
Simulation-based education has been shown to be an effective tool to teach foundational technical skills in various surgical specialties. However, most of the current simulations are limited to generic scenarios and do not allow continuation of the learning curve beyond basic technical skills to prepare for more advanced expertise, such as patient-specific surgical planning. The objective of this study was to evaluate the current medical literature with respect to the utilization and educational value of patient-specific simulations for surgical training.
We performed a systematic review of the literature using Pubmed, Embase, and Scopus focusing on themes of simulation, patient-specific, surgical procedure, and education. The study included randomized controlled trials, cohort studies, and case-control studies published between 2005 and 2016. Two independent reviewers (W.H.R. and N.D) conducted the study appraisal, data abstraction, and quality assessment of the studies.
The search identified 13 studies that met the inclusion criteria; 7 studies employed computer simulations and 6 studies used 3-dimensional (3D) synthetic models. A number of surgical specialties evaluated patient-specific simulation, including neurosurgery, vascular surgery, orthopedic surgery, and interventional radiology. However, most studies were small in size and primarily aimed at feasibility assessments and early validation.
Early evidence has shown feasibility and utility of patient-specific simulation for surgical education. With further development of this technology, simulation-based education may be able to support training of higher-level competencies outside the clinical settingto aid learners in their development of surgical skills.
基于模拟的教育已被证明是一种有效的工具,可用于教授各种外科专业的基础技术技能。然而,目前大多数模拟仅限于通用场景,并且无法在基本技术技能之外继续学习曲线,以准备更高级的专业知识,例如针对患者的手术计划。本研究的目的是评估当前医学文献中关于特定于患者的模拟在外科培训中的使用和教育价值。
我们使用 Pubmed、Embase 和 Scopus 进行了系统的文献综述,重点关注模拟、特定于患者、手术程序和教育等主题。该研究包括 2005 年至 2016 年期间发表的随机对照试验、队列研究和病例对照研究。两名独立评审员(W.H.R. 和 N.D)进行了研究评估、数据提取和研究质量评估。
搜索确定了 13 项符合纳入标准的研究;7 项研究使用了计算机模拟,6 项研究使用了 3 维(3D)合成模型。许多外科专业评估了特定于患者的模拟,包括神经外科、血管外科、骨科和介入放射学。然而,大多数研究规模较小,主要旨在进行可行性评估和早期验证。
早期证据表明特定于患者的模拟对于外科教育具有可行性和实用性。随着这项技术的进一步发展,基于模拟的教育可能能够支持在临床环境之外培训更高水平的能力,以帮助学习者发展手术技能。