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泌尿外科手术教学:“现场”和“半现场”手术演示的患者安全和教育价值。

Surgical teaching in urology: patient safety and educational value of 'LIVE' and 'SEMI-LIVE' surgical demonstrations.

机构信息

Department of Urology, AMC University Hospital, Meibergdreef 9, 1105 AZ, Amsterdam Z-O, The Netherlands.

Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.

出版信息

World J Urol. 2018 Oct;36(10):1673-1679. doi: 10.1007/s00345-018-2291-x. Epub 2018 Apr 21.

Abstract

PURPOSE

To evaluate the opinion of urologists and their audience regarding patient safety and educational value of live surgical demonstrations (LSD) and semi-live surgical demonstrations (semi-LSD).

METHODS

Following the '2017 Challenges in Endourology' meeting, a survey addressing patient safety and the educational value of LSD and semi-LSD was disseminated online to all participants. Survey outcomes of LSD and semi-LSD were compared.

RESULTS

All 279 respondents attended both LSD and semi-LSD. Overall, 53% of said respondents stated that patient safety was always the highest priority for LSD, while 74% noted the same for semi-LSD. The complication risk in LSD was perceived equal by 57% of the respondents when compared to cases of similar difficulty in routine practice, while 38% perceived it as a greater risk. For semi-LSD, the complication risk was perceived equal by 84%, while 5% perceived it to be a greater risk in comparison to general practice. On a scale from 0 (no value) to 10 (highly valuable), the average educational value of LSD and semi-LSD was rated 8.4 and 8.3, respectively. A substantial percentage of the surgeons who perform LSD express concerns that live surgery is not the optimal setting to ensure patient safety.

CONCLUSIONS

LSD remains a popular tool for surgical education among urologists and their audience. However, patient safety remains a concern and is perceived less of a concern for semi-LSD. The educational value of LSD and semi-LSD was scored equally high. Therefore, we should consider to advocate the use of semi-LSD more often.

摘要

目的

评估泌尿科医生及其受众对活体手术演示(LSD)和半活体手术演示(半 LSD)的患者安全性和教育价值的看法。

方法

在“2017 年腔内泌尿学挑战”会议之后,向所有与会者在线分发了一份关于 LSD 和半 LSD 的患者安全性和教育价值的调查。比较了 LSD 和半 LSD 的调查结果。

结果

所有 279 名受访者均参加了 LSD 和半 LSD。总体而言,53%的受访者表示 LSD 的患者安全性始终是最高优先级,而 74%的受访者对半 LSD 也有同样的看法。与常规实践中类似难度的病例相比,57%的受访者认为 LSD 的并发症风险相等,而 38%的受访者认为风险更大。对于半 LSD,84%的受访者认为并发症风险相等,而 5%的受访者认为与一般实践相比风险更大。在 0(无价值)到 10(非常有价值)的评分范围内,LSD 和半 LSD 的平均教育价值分别为 8.4 和 8.3。进行 LSD 的外科医生中有相当一部分表示担心现场手术不是确保患者安全的最佳环境。

结论

LSD 仍然是泌尿科医生及其受众进行外科教育的流行工具。然而,患者安全仍然是一个关注点,并且对半 LSD 的关注度较低。LSD 和半 LSD 的教育价值评分相同。因此,我们应该考虑更多地提倡使用半 LSD。

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