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外科医生的远程指导:一项系统评价。

Telementoring of Surgeons: A Systematic Review.

作者信息

Erridge Simon, Yeung Derek K T, Patel Hitendra R H, Purkayastha Sanjay

机构信息

1 Imperial College London, London, UK.

2 University Hospital North Norway, Tromso, Norway.

出版信息

Surg Innov. 2019 Feb;26(1):95-111. doi: 10.1177/1553350618813250. Epub 2018 Nov 22.

Abstract

BACKGROUND

Telementoring is a technique that has shown potential as a surgical training aid. Previous studies have suggested that telementoring is a safe training modality. This review aimed to review both the technological capabilities of reported telementoring systems as well as its potential benefits as a mentoring modality.

METHODS

A systematic review of the literature, up to July 2017, was carried out in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Study quality was assessed using the Oxford Levels of Evidence proforma. Data were extracted regarding technical capabilities, bandwidth, latency, and costs. Additionally, the primary aim and key results were extracted from each study and analyzed.

RESULTS

A total of 66 studies were identified for inclusion. In all, 48% of studies were conducted in general surgery; 22 (33%), 24 (36%), and 20 (30%) of studies reported telementoring that occurred within the same hospital, outside the hospital, and outside the country, respectively. Sixty-four (98%) of studies employed video and audio and 38 (58%) used telestration. Twelve separate studies directly compared telementoring against on-site mentoring. Seven (58%) showed no difference in outcomes between telementoring and on-site mentoring. No study found telementoring to result in poorer postoperative outcomes.

CONCLUSIONS

The results of this review suggest that telementoring has a similar safety and efficacy profile as on-site mentoring. Future analysis to determine the potential benefits and pitfalls to surgical education through telementoring are required to determine the exact role it shall play in the future. Technological advances to improve remote connectivity would also aid the uptake of telementoring on a larger scale.

摘要

背景

远程指导是一种已显示出作为手术培训辅助手段潜力的技术。先前的研究表明远程指导是一种安全的培训方式。本综述旨在回顾已报道的远程指导系统的技术能力及其作为一种指导方式的潜在益处。

方法

按照PRISMA(系统评价和Meta分析的首选报告项目)指南,对截至2017年7月的文献进行了系统综述。使用牛津证据水平模板评估研究质量。提取了有关技术能力、带宽、延迟和成本的数据。此外,从每项研究中提取主要目的和关键结果并进行分析。

结果

共确定66项研究纳入。总体而言,48%的研究在普通外科进行;分别有22项(33%)、24项(36%)和20项(30%)研究报告的远程指导发生在同一医院内、医院外和国外。64项(98%)研究采用了视频和音频,38项(58%)使用了电子绘图。12项独立研究直接将远程指导与现场指导进行了比较。7项(58%)研究表明远程指导和现场指导在结果上无差异。没有研究发现远程指导会导致术后结果更差。

结论

本综述结果表明,远程指导与现场指导具有相似的安全性和有效性。需要进一步分析以确定通过远程指导对外科教育的潜在益处和缺陷,从而确定其在未来的确切作用。改善远程连接的技术进步也将有助于更广泛地采用远程指导。

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