Yokoyama Hitoshi
Department of Cardiovascular Surgery, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima, 960-8072, Japan.
Surg Today. 2019 Apr;49(4):300-310. doi: 10.1007/s00595-018-1747-3. Epub 2018 Dec 7.
This review summarizes the recent progress made in understanding the skill acquisition process of achieving expert status in various fields that require fine motor skills. We discuss the attempts to apply this progress to develop competent surgeons.
We reviewed the existing literature, using the keywords "surgical training", "skill acquisition", and "simulator-based training", using Medline, as well as recent books and chapters related to these issues. We also summarized the role of simulator-based training in basic skill acquisition through deliberate practice. Other aspects of surgical skills, such as steps taken to improve motor skills, technical skill in the operating room, and competency level from novice to expert, were reviewed.
The common element of practice to develop top-ranking experts in various fields is deliberate practice. Long-term repetitive practice is supported by the individual's mental attitude: guts, resilience, initiative, tenancy (GRIT). GRIT can be imparted using a teaching method that supports a "growth mindset".
Recent theoretical advances in skill acquisition can be applied to surgical residency training, while intense efforts are being made to improve the curriculum and training environment.
本综述总结了在理解需要精细运动技能的各个领域中获得专家地位的技能习得过程方面取得的最新进展。我们讨论了将这一进展应用于培养合格外科医生的尝试。
我们使用关键词“外科培训”“技能习得”和“基于模拟器的培训”在Medline上检索现有文献，以及近期与这些问题相关的书籍和章节。我们还总结了基于模拟器的培训在通过刻意练习获得基本技能方面的作用。对外科技能的其他方面进行了综述，如提高运动技能所采取的步骤、手术室中的技术技能以及从新手到专家的能力水平。
在各个领域培养顶尖专家的实践的共同要素是刻意练习。长期重复练习得到个人心态的支持：勇气、适应力、主动性、毅力（坚毅）。可以使用支持“成长型思维模式”的教学方法来培养坚毅。
技能习得方面的最新理论进展可应用于外科住院医师培训，同时正在大力改进课程和培训环境。
