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整形外科学住院医师培训项目中模拟训练的现状:一项综述。

Current status of simulation training in plastic surgery residency programs: A review.

作者信息

Thomson Jennifer E, Poudrier Grace, Stranix John T, Motosko Catherine C, Hazen Alexes

机构信息

Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, New York, NY, USA.

出版信息

Arch Plast Surg. 2018 Sep;45(5):395-402. doi: 10.5999/aps.2017.01585. Epub 2018 Sep 15.

Abstract

Increased emphasis on competency-based learning modules and widespread departure from traditional models of Halstedian apprenticeship have made surgical simulation an increasingly appealing component of medical education. Surgical simulators are available in numerous modalities, including virtual, synthetic, animal, and non-living models. The ideal surgical simulator would facilitate the acquisition and refinement of surgical skills prior to clinical application, by mimicking the size, color, texture, recoil, and environment of the operating room. Simulation training has proven helpful for advancing specific surgical skills and techniques, aiding in early and late resident learning curves. In this review, the current applications and potential benefits of incorporating simulation-based surgical training into residency curriculum are explored in depth, specifically in the context of plastic surgery. Despite the prevalence of simulation-based training models, there is a paucity of research on integration into resident programs. Current curriculums emphasize the ability to identify anatomical landmarks and procedural steps through virtual simulation. Although transfer of these skills to the operating room is promising, careful attention must be paid to mastery versus memorization. In the authors' opinions, curriculums should involve step-wise employment of diverse models in different stages of training to assess milestones. To date, the simulation of tactile experience that is reminiscent of real-time clinical scenarios remains challenging, and a sophisticated model has yet to be established.

摘要

对基于能力的学习模块的日益重视以及对传统霍尔斯特德学徒模式的广泛背离,使得手术模拟成为医学教育中越来越有吸引力的组成部分。手术模拟器有多种形式,包括虚拟、合成、动物和非活体模型。理想的手术模拟器应通过模拟手术室的大小、颜色、质地、反冲力和环境,在临床应用之前促进手术技能的获取和完善。模拟训练已被证明有助于提高特定的手术技能和技术,有助于早期和晚期住院医师的学习曲线。在本综述中,深入探讨了将基于模拟的手术训练纳入住院医师课程的当前应用和潜在益处,特别是在整形外科领域。尽管基于模拟的训练模式很普遍,但关于将其整合到住院医师项目中的研究却很少。当前的课程强调通过虚拟模拟识别解剖标志和手术步骤的能力。尽管将这些技能转移到手术室很有前景,但必须仔细关注掌握与记忆的区别。作者认为,课程应在培训的不同阶段逐步采用多种模型来评估里程碑。迄今为止,模拟类似于实时临床场景的触觉体验仍然具有挑战性,尚未建立复杂的模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d9ac/6177637/68e9566b19e3/aps-2017-01585f1.jpg

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