Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Department of Surgery, Beth Israel Deaconess Medical Center, 110 Francis Street, Suite 9B, Boston, MA, 02215, USA.
Surg Endosc. 2018 Aug;32(8):3640-3645. doi: 10.1007/s00464-018-6095-2. Epub 2018 Feb 13.
The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has developed the fundamental use of surgical energy (FUSE) didactic curriculum in order to further understanding of the safe use of surgical energy. The virtual electrosurgical skill trainer (VEST) is being developed as a complementary simulation-based curriculum, with several modules already existing. Subsequently, a new VEST module has been developed about dispersive electrode placement. The purpose of this study is to assess knowledge about dispersive electrode placement in surgeons and surgical trainees in addition to describing a new VEST module.
Forty-six subjects (n = 46) were recruited for participation at the 2016 SAGES conference Learning Center. Subjects were asked to complete demographic surveys, a five-question pre-test, and a five-question post-test after completing the VEST dispersive electrode module. Subjects were then asked to rate different aspects of the module using a five-point Likert scale questionnaire.
Mean pre-simulator and post-simulator assessment scores were 1.5 and 3.4, respectively, with Wilcoxon signed rank analysis showing a significant difference in the means (p < 0.05). Subjects were grouped by the presence (n = 12) or absence (n = 31) of prior FUSE experience and by training level. Mann-Whitney U testing showed no significant difference in pre-simulator assessment scores between attending surgeons and trainees (p > 0.05). In those with and without FUSE exposure, a significant difference (p < 0.05) was seen in pre-simulator assessment scores, and no significant difference in Likert scale assessment scores was seen.
This study demonstrated a new VEST educational module. Consistently high Likert assessment scores showed that users felt that the VEST module helped their understanding of dispersive electrode placement. Additionally, the study reflected a potential knowledge deficit in the safe use of dispersive electrodes in the surgical community, also demonstrating that even some exposure to the FUSE curriculum developed by SAGES provides increased awareness about dispersive electrode use.
美国胃肠内镜外科学会（SAGES）制定了基本外科能量使用（FUSE）教学课程，以进一步了解安全使用外科能量。虚拟电外科技能训练器（VEST）作为补充模拟课程正在开发中，已经存在几个模块。随后，开发了一个关于分散电极放置的新 VEST 模块。本研究的目的是评估外科医生和外科受训者对分散电极放置的知识，同时描述一个新的 VEST 模块。
在 2016 年 SAGES 会议学习中心招募了 46 名受试者（n=46）参加。受试者被要求完成人口统计学调查、五项预测试题和五项 VEST 分散电极模块完成后的后测试题。然后，受试者被要求使用五点 Likert 量表问卷对模块的不同方面进行评分。
平均预模拟器和后模拟器评估分数分别为 1.5 和 3.4，Wilcoxon 符号秩检验显示平均值存在显著差异（p<0.05）。根据是否具有（n=12）或缺乏（n=31）先前的 FUSE 经验以及培训水平对受试者进行分组。Mann-Whitney U 检验显示，主治医生和受训者之间的预模拟器评估分数没有显著差异（p>0.05）。在具有和不具有 FUSE 暴露的受试者中，预模拟器评估分数存在显著差异（p<0.05），但在 Likert 量表评估分数方面没有显著差异。
本研究展示了一个新的 VEST 教育模块。一致的高 Likert 评估分数表明，用户认为 VEST 模块有助于他们理解分散电极的放置。此外，该研究反映了外科界在安全使用分散电极方面存在潜在的知识缺陷，也表明即使接触 SAGES 制定的 FUSE 课程也能提高对分散电极使用的认识。
