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基于 TAPP 清单的教学系统可提高新手的表现:一项多中心随机试验。

Educational system based on the TAPP checklist improves the performance of novices: a multicenter randomized trial.

机构信息

Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Kita 15 Nishi 7, Kita-ku, Sapporo, Japan.

Clinical Simulation Center, Hokkaido University, Sapporo, Japan.

出版信息

Surg Endosc. 2018 May;32(5):2480-2487. doi: 10.1007/s00464-017-5950-x. Epub 2017 Nov 9.

Abstract

BACKGROUND

Despite recent developments in surgical education, obstacles including inadequate budget, limited human resources, and a scarcity of time have limited its widespread adoption. To provide systematic training for laparoscopic inguinal hernia repair, we had previously developed and validated a checklist to evaluate the recorded performance of transabdominal preperitoneal (TAPP) repair. We had also developed an educational system that included didactic materials based on the TAPP checklist and incorporated remote evaluation and feedback system. The aim of this study was to evaluate the educational impact of the TAPP education system on novice surgeons.

METHODS

Residents and surgeons from participating hospitals, who had performed 0 or 1 TAPP procedure, were randomly assigned to the intervention group (IG), who trained using this new educational tool, and the control group (CG), who trained using the conventional system. Their surgical videos were rated by blinded raters. All participants performed their first case prior to randomization. The primary outcome was improvement of TAPP checklist score from the first to the third case.

RESULTS

Eighteen participants from 9 institutes were recruited for this study. Seven participants in the IG and 5 participants in the CG were included in the final analysis. The participants in the IG demonstrated significant improvement in their TAPP performance (p = 0.044) from their first case to their third case, whereas their counterparts in the CG failed to make any significant progress during the same period (p = 0.581).

CONCLUSION

The new TAPP educational system was effective in improving the TAPP performance of novice surgeons.

摘要

背景

尽管外科教育最近取得了进展,但由于预算不足、人力资源有限以及时间紧张等障碍,其广泛采用受到了限制。为了对腹腔镜腹股沟疝修补术进行系统培训,我们之前开发并验证了一种检查表,用于评估经腹腹膜前(TAPP)修补术的记录表现。我们还开发了一个教育系统,其中包括基于 TAPP 检查表的教学材料,并纳入了远程评估和反馈系统。本研究旨在评估 TAPP 教育系统对新手外科医生的教育影响。

方法

来自参与医院的住院医师和外科医生,他们已经完成了 0 或 1 例 TAPP 手术,被随机分配到干预组(IG),他们使用这个新的教育工具进行培训,以及对照组(CG),他们使用传统系统进行培训。他们的手术视频由盲评人进行评分。所有参与者在随机分组前都进行了第一次手术。主要结果是 TAPP 检查表评分从第一次到第三次手术的提高。

结果

本研究共招募了 9 家医院的 18 名参与者。IG 中有 7 名参与者和 CG 中有 5 名参与者进入了最终分析。IG 组的参与者在 TAPP 表现方面表现出显著改善(p=0.044),从他们的第一次手术到第三次手术,而 CG 组的参与者在同一时期没有取得任何显著进展(p=0.581)。

结论

新的 TAPP 教育系统在提高新手外科医生的 TAPP 表现方面是有效的。

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