Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.
Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California.
J Surg Educ. 2018 May-Jun;75(3):820-827. doi: 10.1016/j.jsurg.2017.09.020. Epub 2017 Oct 14.
The landscape of graduate medical education has changed dramatically over the past decade and the traditional apprenticeship model has undergone scrutiny and modifications. The mandate of the 80-hour work-week, the introduction of integrated residency programs, increased global awareness about patient safety along with financial constraints have spurred changes in graduate educational practices. In addition, new technologies, more complex procedures, and a host of external constraints have changed where and how we teach technical and procedural skills. Simulation-based training has been embraced by the surgical community and has quickly become an essential component of most residency programs as a method to add efficacy to the traditional learning model. The purpose of this paper is twofold: (1) to describe the development of a perfused cadaver model with dynamic vital sign regulation, and (2) to assess the impact of a curriculum using this model and real world scenarios to teach surgical skills and error management. By providing a realistic training environment our aim is to enhance the acquisition of surgical skills and provide a more thorough assessment of resident performance. Twenty-six learners participated in the scenarios. Qualitative data showed that participants felt that the simulation model was realistic, and that participating in the scenarios helped them gain new knowledge, learn new surgical techniques and increase their confidence performing the skill in a clinical setting. Identifying the importance of both technical and nontechnical skills in surgical education has hastened the need for more realistic simulators and environments in which they are placed. Team members should be able to interact in ways that allow for a global display of their skills thus helping to provide a more comprehensive assessment by faculty and learners.
在过去的十年中,研究生医学教育的格局发生了巨大变化,传统的学徒模式受到了审查和修改。每周 80 小时工作时间的规定、综合住院医师培训计划的引入、对患者安全的全球意识的提高以及财政限制,促使研究生教育实践发生了变化。此外,新技术、更复杂的程序以及一系列外部限制因素改变了我们教授技术和程序技能的地点和方式。基于模拟的培训已被外科界接受,并迅速成为大多数住院医师培训计划的重要组成部分,作为一种为传统学习模式增加效果的方法。本文的目的有两个:(1) 描述具有动态生命体征调节功能的灌注尸体模型的开发,以及 (2) 评估使用该模型和真实场景来教授手术技能和错误管理的课程的影响。通过提供逼真的培训环境,我们旨在提高手术技能的获取,并更全面地评估住院医师的表现。26 名学习者参与了这些场景。定性数据显示,参与者认为模拟模型非常逼真,参与场景帮助他们获得了新知识,学习了新的手术技术,并提高了他们在临床环境中执行技能的信心。在外科教育中识别技术和非技术技能的重要性,加速了对更逼真的模拟器和模拟环境的需求,以便团队成员能够以允许全面展示其技能的方式进行互动,从而帮助教师和学习者进行更全面的评估。