Chen Philip G, Chang Daniel R, Weitzel Erik K, Peel Jennifer, Chandra Rakesh K, McMains K Christopher
Department of Otolaryngology-Head and Neck Surgery, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA.
Allergy Rhinol (Providence). 2016 Jan 1;7(4):244-248. doi: 10.2500/ar.2016.7.0180.
Simulation is currently recognized as an effective surgical training tool. However, no standardized curriculum exists for endoscopic sinus surgery (ESS) simulation training. The goal of this study was to obtain an understanding of current ESS simulation use to aid the future development of an ESS training curriculum.
A 14-question survey regarding sinus simulation in residency training was developed through the education committee of the American Rhinologic Society. The survey was administered to academic American Rhinologic Society members in the United States, Canada, and Puerto Rico. The participants provided information regarding the type, amount, and effectiveness of simulation use in their residency program.
Responses were received from 67 training programs; 45% of the programs endorsed using simulation training, although only 23.9% used ESS simulation, and all the programs used cadavers. Only 12.5% of respondent programs required ESS simulation training before operating on live patients, and trainees had an average of <6 hours of simulation training before live operations. A majority of respondents observed subjective improvement in residents' endoscope handling, dexterity, and understanding of anatomy after ESS simulation. The greatest obstacles identified were associated cost and lack of realistic simulators.
A majority of responders observed improved surgical technique and knowledge in residents after simulation training. However, <25% of the survey responders used ESS simulation and cited cost and limited availability as the most common barriers. A curriculum of validated simulators has potential to improve the quality of ESS training during residency.
模拟目前被认为是一种有效的外科手术训练工具。然而，内镜鼻窦手术（ESS）模拟训练尚无标准化课程。本研究的目的是了解当前ESS模拟的使用情况，以辅助ESS训练课程的未来发展。
通过美国鼻科学会教育委员会制定了一项关于住院医师培训中鼻窦模拟的14题调查问卷。该问卷发放给了美国、加拿大和波多黎各的美国鼻科学会学术会员。参与者提供了有关其住院医师培训项目中模拟使用的类型、数量和效果的信息。
共收到67个培训项目的回复；45%的项目认可使用模拟训练，尽管只有23.9%使用ESS模拟，且所有项目都使用尸体。只有12.5%的受访项目要求在对活体患者进行手术前进行ESS模拟训练，实习生在进行活体手术前平均接受的模拟训练时间少于6小时。大多数受访者观察到，在进行ESS模拟后，住院医师在内镜操作、灵活性和解剖学理解方面有主观上的提高。所确定的最大障碍是相关成本和缺乏逼真的模拟器。
大多数受访者观察到模拟训练后住院医师的手术技术和知识有所提高。然而，不到25%的受访者使用ESS模拟，并将成本和可用性有限列为最常见的障碍。经过验证的模拟器课程有潜力提高住院医师培训期间ESS训练的质量。
