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内镜耳部手术技能培训提高医学生的表现。

Endoscopic Ear Surgery Skills Training Improves Medical Student Performance.

机构信息

Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

出版信息

J Surg Educ. 2018 Nov;75(6):1480-1485. doi: 10.1016/j.jsurg.2018.04.015. Epub 2018 May 10.

Abstract

OBJECTIVE

Analyze medical student performance using an endoscopic ear surgery (EES) skills trainer over time.

DESIGN

Simulation experience.

SETTING

Surgical skills lab.

PARTICIPANTS

Five medical students and 1 expert surgeon completed 3 training sessions using an EES trainer to practice specific tasks designed to improve instrument control. During each session, participants performed 3 tasks, such as placing beads onto wires, 5 times per session for a total of 15 trials per task. Exercises were scored based on completion time. Results were compared before and after training. Pre- and post-task surveys were administered.

RESULTS

Prior to skills training, 0% of medical students reported feeling comfortable holding an endoscope or ear instruments. For students, overall mean completion times decreased significantly for each exercise by the conclusion of the training experience: placing beads on wires improved from 152 to 44 seconds (p < 0.001), placing simulated prostheses from 264 to 93 seconds (p < 0.001), and navigating a pattern from 193 to 66 seconds (p = 0.002). Individual analysis showed varying learning curves among participants and between exercises, with some students exhibiting rapid improvement. At the conclusion of training, 80% of students felt comfortable holding the endoscope and using otologic instruments, and 100% were satisfied with the experience.

CONCLUSIONS

Novice surgeons can exhibit significant skill improvement with repetitive practice on an EES trainer. Variable baseline skill and improvement rates highlight the individual characteristics of skill acquisition, which may be important factors during otolaryngology and endoscopic ear surgery training.

摘要

目的

通过使用内镜耳部手术(EES)技能训练器随时间分析医学生的表现。

设计

模拟体验。

设置

手术技能实验室。

参与者

5 名医学生和 1 名专家外科医生使用 EES 训练器完成了 3 次培训课程,以练习旨在提高器械控制能力的特定任务。在每次训练中,参与者完成了 3 项任务,如将珠子放置在导线上,每次训练 5 次,每次任务共进行 15 次尝试。练习基于完成时间进行评分。比较训练前后的结果。在训练前后进行了任务调查。

结果

在技能培训之前,0%的医学生表示对握持内窥镜或耳部器械感到舒适。对于学生来说,每个练习的总体平均完成时间在培训结束时都显著缩短:将珠子放在线上的时间从 152 秒缩短至 44 秒(p<0.001),将模拟假体放置的时间从 264 秒缩短至 93 秒(p<0.001),以及导航模式的时间从 193 秒缩短至 66 秒(p=0.002)。个体分析显示,参与者之间和练习之间的学习曲线各不相同,一些学生表现出快速进步。在培训结束时,80%的学生对握持内窥镜和使用耳科器械感到舒适,100%的学生对体验感到满意。

结论

通过在 EES 训练器上进行重复练习,新手外科医生可以显著提高技能。不同的基线技能和提高率突出了技能获取的个体特征,这可能是耳鼻喉科和内镜耳部手术培训中的重要因素。

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