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阴茎植入手术的模拟训练:通过尸体实验室训练评估手术信心和知识水平。

Simulation Training in Penile Implant Surgery: Assessment of Surgical Confidence and Knowledge With Cadaveric Laboratory Training.

作者信息

Lentz Aaron C, Rodríguez Dayron, Davis Leah G, Apoj Michel, Kerfoot B Price, Perito Paul, Henry Gerard, Jones LeRoy, Carrion Rafael, Mulcahy John J, Munarriz Ricardo

机构信息

Division of Urologic Surgery, Duke University, Raleigh, NC, USA.

Department of Urology, Boston Medical Center, Boston, MA, USA.

出版信息

Sex Med. 2018 Dec;6(4):332-338. doi: 10.1016/j.esxm.2018.09.001. Epub 2018 Oct 24.

Abstract

INTRODUCTION

Constraints on surgical resident training (work-hour mandates, shorter training programs, etc.) and availability of expert surgical educators may limit the acquisition of prosthetic surgical skills. As a result, training courses are being conducted to augment the prosthetic surgery learning experience.

AIM

To evaluate the impact of a hands-on cadaver-based teaching program on resident procedural knowledge and procedural confidence with placement of a penile prosthesis.

MAIN OUTCOME MEASURE

Changes in procedural knowledge and self-confidence following a focused training program on penile prosthetics.

METHODS

As part of the 2017 Society of Urologic Prosthetic Surgeons and the Sexual Medicine Society of North America Annual Meeting, 31 urology residents participated in a simulation lab in prosthetic urology. The lab included didactic lectures and a hands-on cadaveric laboratory. Participants completed surveys before and after the course. Wilcoxon Signed Rank tests for matched pairs were used to compare respondents' pre- and postcourse knowledge (% questions answered correctly) and confidence ratings. Prior implant experience was assessed.

RESULTS

31 residents participated in this study. The majority of the participants were 4th- (41.9%) and 5th-year residents (38.7%). Participants showed a significant improvement in procedural knowledge test scores (68.8±13.4 vs 74.2 ± 13.0, P < .05) and self-reported increased median surgical confidence levels (4 vs 3, P value < .001) after completion of the cadaveric course. Subgroup analysis demonstrated that residents with prosthetic surgery experience of <10 cases benefited the most. In addition, improvement in surgical confidence levels observed was greater than the improvement in surgical knowledge. The overall cost of the simulation training course was approximately $1,483 per resident.

CONCLUSION

Simulation training in prosthetic surgery seems to improve surgical confidence and knowledge. Further research is needed to better understand the benefits and limitations of simulation training. Lentz AC, Rodríguez D, Davis LG. Simulation training in penile implant surgery: Assessment of surgical confidence and knowledge with cadaveric laboratory training. Sex Med 2018;6:332-338.

摘要

引言

对外科住院医师培训的限制(工作时间规定、缩短培训项目等)以及专家外科教育工作者的可获得性可能会限制假体手术技能的掌握。因此,正在开展培训课程以增强假体手术的学习体验。

目的

评估基于尸体的实践教学项目对住院医师阴茎假体植入手术的操作知识和操作信心的影响。

主要观察指标

阴茎假体聚焦培训项目后操作知识和自信心的变化。

方法

作为2017年泌尿生殖假体外科医生协会和北美性医学协会年会的一部分,31名泌尿外科住院医师参加了泌尿生殖假体模拟实验室。该实验室包括理论讲座和尸体实践实验室。参与者在课程前后完成了调查问卷。采用配对样本的Wilcoxon符号秩检验来比较受访者课程前后的知识(正确回答问题的百分比)和信心评分。评估了先前的植入经验。

结果

31名住院医师参与了本研究。大多数参与者是四年级(41.9%)和五年级住院医师(38.7%)。完成尸体课程后,参与者的操作知识测试成绩有显著提高(68.8±13.4对74.2±13.0,P<.05),自我报告的手术信心中位数水平有所提高(4对3,P值<.001)。亚组分析表明,假体手术经验少于10例的住院医师受益最大。此外,观察到的手术信心水平的提高大于手术知识的提高。模拟培训课程的每位住院医师总成本约为1483美元。

结论

假体手术模拟培训似乎能提高手术信心和知识。需要进一步研究以更好地理解模拟培训的益处和局限性。伦茨AC、罗德里格斯D、戴维斯LG。阴茎植入手术的模拟培训:尸体实验室培训对手术信心和知识的评估。性医学2018;6:332-338。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/34ef/6302135/df02b77ac86a/gr1.jpg

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