Chen Chi-Ya, Ragle Claude A, Lencioni Rachael, Fransson Boel A
Department of Veterinary Clinical Sciences, Washington State University, Pullman, Washington.
Vet Surg. 2017 Nov;46(8):1187-1197. doi: 10.1111/vsu.12729. Epub 2017 Oct 9.
To compare the effects of 2 training curricula on laparoscopic skills and performance of simulated surgery in veterinary students.
Prospective study.
Veterinary students (n = 33) with no prior hands-on experience in minimally invasive surgery.
Basic laparoscopic skills (BLS) were assessed based on 5 modified McGill inanimate system for training and evaluation of laparoscopic skills. Motion metrics and an objective structured assessment of technical skills (OSATS) were used to evaluate surgical skills during a simulated laparoscopic cholecystectomy performed in an augmented reality simulator. Students were randomly assigned to either skill-based (group A) or procedural-based (group B) training curriculum. Both tests were performed prior to and after a 10-session training curriculum.
Post-training BLS results were improved in both training groups (P < .001). Seven participants completed both presimulated and postsimulated laparoscopic cholecystectomy, preventing paired analysis. Based on motion metrics analysis, participants completed tasks in a shorter time (P = .0187), and with better economy of movement (P = .0457) after training. No difference was detected in OSATS before and after training.
Both training curricula improved BLS, but significant differences were not detected between the procedural-based training program and basic skills training alone in veterinary students. Motion metrics such as time, economy of movement, and instrument path were superior to an OSATS, when assessing surgical performance. Further studies are needed to compare the effects of different simulators on the training of veterinarians with diverse laparoscopic surgical experience.
比较两种培训课程对兽医专业学生腹腔镜技能及模拟手术操作的影响。
前瞻性研究。
此前无微创手术实践经验的兽医专业学生(n = 33)。
基于5项改良的用于腹腔镜技能培训与评估的麦吉尔非活体系统对基础腹腔镜技能(BLS)进行评估。在增强现实模拟器中进行模拟腹腔镜胆囊切除术时,使用运动指标和客观结构化技术技能评估(OSATS)来评价手术技能。学生被随机分配到基于技能的培训组(A组)或基于程序的培训组(B组)。在为期10节的培训课程前后分别进行两项测试。
两个培训组的培训后BLS结果均有所改善(P < .001)。7名参与者完成了模拟前和模拟后的腹腔镜胆囊切除术,无法进行配对分析。基于运动指标分析,培训后参与者完成任务的时间更短(P = .0187),动作经济性更好(P = .0457)。培训前后OSATS未检测到差异。
两种培训课程均提高了BLS,但在兽医专业学生中,基于程序的培训方案与单纯的基础技能培训之间未检测到显著差异。在评估手术操作时,诸如时间、动作经济性和器械路径等运动指标优于OSATS。需要进一步研究来比较不同模拟器对具有不同腹腔镜手术经验的兽医培训效果的影响。