Chen Chi-Ya, Elarbi Mustafa, Ragle Claude A, Fransson Boel A
J Am Vet Med Assoc. 2019 Jan 1;254(1):113-123. doi: 10.2460/javma.254.1.113.
OBJECTIVE To develop and evaluate a high-fidelity simulated laparoscopic ovariectomy (SLO) model for surgical training and testing. DESIGN Evaluation study. SAMPLE 15 veterinary students (novice group), 5 veterinary surgical interns or residents (intermediate group), and 6 veterinary surgeons (experienced group). PROCEDURES Laparoscopic surgery experience was assessed by questionnaire and visual analog scales. Basic laparoscopic skills were assessed with a commercial training model. A commercial canine abdomen model was customized with a high-fidelity simulated canine female genital tract. Each subject's SLO performance (laparoscopic entry, dissection along marked planes, and left ovariectomy) was evaluated by measurement of surgical time and errors (splenic puncture and deviation from dissection marks) and with global and operative component rating scales. Construct and concurrent validity were assessed by correlation of SLO results with self-estimated measures of experience level and with basic laparoscopic skills test results, respectively. Face validity was assessed with a questionnaire completed by intermediate and experienced group participants. RESULTS 13 participants (3/15, 5/5, and 5/6 in the novice, intermediate, and experienced groups, respectively) completed SLO within the preset time. No difference in errors was found among groups. Completion time was significantly correlated with self-estimated experience level (r = -0.626), confirming construct validity, and with basic laparoscopic skills scores (r = -0.552) and global (r = -0.624) and operative component (r = -0.624) rating scale scores, confirming concurrent validity. Overall mean face validity score was low (64.2/100); usefulness of the model for surgical training received the highest score (8/10). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested the SLO model may be a useful surgical training tool. Further studies are needed to confirm usefulness of the model in veterinary laparoscopy training.
目的 开发并评估一种用于手术培训和测试的高保真模拟腹腔镜卵巢切除术（SLO）模型。 设计 评估研究。 样本 15 名兽医专业学生（新手组）、5 名兽医外科实习生或住院医生（中级组）和 6 名兽医外科医生（经验丰富组）。 程序 通过问卷和视觉模拟量表评估腹腔镜手术经验。 使用商业培训模型评估基本腹腔镜技能。 用高保真模拟犬雌性生殖道定制一个商业犬腹部模型。 通过测量手术时间和错误（脾穿刺和偏离解剖标记）以及使用整体和手术组成部分评分量表来评估每个受试者的 SLO 表现（腹腔镜进入、沿标记平面进行解剖以及左侧卵巢切除术）。 分别通过将 SLO 结果与经验水平的自我估计指标以及基本腹腔镜技能测试结果进行相关性分析来评估结构效度和同时效度。 通过中级组和经验丰富组参与者填写的问卷评估表面效度。 结果 13 名参与者（新手组、中级组和经验丰富组分别为 3/15、5/5 和 5/6）在预设时间内完成了 SLO。 各组之间在错误方面未发现差异。 完成时间与自我估计的经验水平显著相关（r = -0.626），证实了结构效度，与基本腹腔镜技能得分（r = -0.552）、整体（r = -0.624）和手术组成部分（r = -0.624）评分量表得分显著相关，证实了同时效度。 总体平均表面效度得分较低（64.2/100）；该模型对手术培训的有用性得分最高（8/10）。 结论及临床意义 结果表明 SLO 模型可能是一种有用的手术培训工具。 需要进一步研究以证实该模型在兽医腹腔镜培训中的有用性。
