Frithioff Andreas, Sørensen Mads Sølvsten, Andersen Steven Arild Wuyts
Department of Otorhinolaryngology, Head and Neck Surgery, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
The Simulation Centre, Rigshospitalet, Center for HR, The Capital Region, Copenhagen Academy for Medical Education and Simulation (CAMES), Copenhagen, Denmark.
Eur Arch Otorhinolaryngol. 2018 Feb;275(2):357-363. doi: 10.1007/s00405-017-4824-0. Epub 2017 Nov 28.
In otorhinolaryngology training, introduction to temporal bone surgery through hands-on practice on cadaveric human temporal bones is the gold-standard training method before commencing supervised surgery. During the recent decades, the availability of such specimens and the necessary laboratory facilities for training seems to be decreasing. Alternatives to traditional training can consist of drilling artificial models made of plaster or plastic but also virtual reality (VR) simulation. Nevertheless, the integration and availability of these alternatives into specialist training programs remain unknown.
We conducted a questionnaire study mapping current status on temporal bone training and included responses from 113 departments from 23 countries throughout Europe.
In general, temporal bone training during residency in ORL is organized as in-house training, or as participation in national or international temporal bone courses or some combination hereof. There are considerable differences in the availability of training facilities for temporal bone surgery and the number of drillings each ORL trainee can perform. Cadaveric dissection is still the most commonly used training modality.
VR simulation and artificial models are reported to be used at many leading training departments already. Decreasing availability of cadavers, lower costs of VR simulation and artificial models, in addition to established evidence for a positive effect on the trainees' competency, were reported as the main reasons. Most remaining departments expect to implement VR simulation and artificial models for temporal bone training into their residency programs in the near future.
在耳鼻咽喉科培训中，在开始有监督的手术之前，通过对人类尸体颞骨进行实践操作来引入颞骨手术是金标准培训方法。在最近几十年里，此类标本的可获得性以及用于培训的必要实验室设施似乎在减少。传统培训的替代方法可以包括对由石膏或塑料制成的人工模型进行钻孔，也可以是虚拟现实（VR）模拟。然而，这些替代方法在专科培训项目中的整合情况和可获得性仍然未知。
我们开展了一项问卷调查研究，以了解颞骨培训的现状，并纳入了来自欧洲23个国家113个科室的回复。
总体而言，耳鼻咽喉科住院医师培训期间的颞骨培训是作为内部培训、或参加国内或国际颞骨课程、或二者的某种组合来组织的。颞骨手术培训设施的可获得性以及每个耳鼻咽喉科住院医师能够进行的钻孔数量存在很大差异。尸体解剖仍然是最常用的培训方式。
据报道，许多领先的培训科室已经在使用VR模拟和人工模型。尸体可获得性下降、VR模拟和人工模型成本降低，以及已有的对学员能力有积极影响的证据，被报告为主要原因。大多数其余科室预计在不久的将来将把用于颞骨培训的VR模拟和人工模型纳入其住院医师培训项目。
