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关节镜模拟训练能否提高三角测量和探查技能?一项随机对照试验。

Does Arthroscopic Simulation Training Improve Triangulation and Probing Skills? A Randomized Controlled Trial.

机构信息

Department of Orthopaedic Surgery, University of Colorado, School of Medicine, Aurora, Colorado.

Arthrex Inc., Naples, Florida.

出版信息

J Surg Educ. 2019 Jul-Aug;76(4):1131-1138. doi: 10.1016/j.jsurg.2019.01.008. Epub 2019 Mar 4.

Abstract

OBJECTIVE

To determine the effectiveness of simulator training on basic arthroscopic skills utilizing a novel, low-cost arthroscopic triangulation training system.

DESIGN

A randomized controlled trial of subjects without prior arthroscopy training was conducted, with participants randomized to receive either a fixed protocol of simulation training on a triangulation simulation model (30 minutes of training for 4 consecutive days), or no training. On Days 1 and 5, all participants were evaluated on 3 simulated arthroscopic tasks by an independent observer. Variables analyzed included how many times portals were changed, the time it took to complete the tasks, and the task completion rate.

SETTING

Arthrex Inc., Naples, FL.

PARTICIPANTS

Thirty-six participants (92% male, average 28 ± 5 years) with no prior arthroscopy training were randomized into 2 groups, with 17 in the training group (T) and 19 in the no-training group (NT).

RESULTS

On Day 1, there was no difference in rate of task completion between the T group and NT groups (41% versus 53%, p = 0.52). On Day 5, significantly more participants in the T group completed all tasks compared to the NT group (100% versus 63%, p = 0.008). Participants in the T group had significantly improved task completion times on Day 5 versus Day 1 (p < 0.05). Participants in the NT group had a significantly improved task completion time for Task 1 on Day 5 versus Day 1 (p = 0.037); no differences were found for Tasks 2 or 3. On Day 5, participants in the T group required significantly fewer portal changes compared to the NT group (2.35 ± 2.29 versus 6.95 ± 8.55, p = 0.039).

CONCLUSIONS

Simulation training on a simple, low-cost arthroscopic triangulation training system resulted in an overall improvement in arthroscopic probing and triangulation skills within 1 week of training, with significantly decreased task completion times and increased efficiency of movement.

摘要

目的

利用新型低成本关节镜三角训练系统,确定模拟器训练对基本关节镜技能的有效性。

设计

对没有关节镜操作经验的受试者进行随机对照试验,将参与者随机分为接受三角模拟模型固定方案的模拟训练(连续 4 天每天 30 分钟训练)或不训练。在第 1 天和第 5 天,所有参与者均由独立观察者评估 3 项模拟关节镜任务。分析的变量包括改变入路的次数、完成任务所需的时间和任务完成率。

地点

佛罗里达州那不勒斯市 Arthrex 公司。

参与者

36 名参与者(92%为男性,平均 28±5 岁),没有关节镜操作经验,随机分为 2 组,17 名在训练组(T),19 名在无训练组(NT)。

结果

第 1 天,T 组和 NT 组的任务完成率没有差异(41%比 53%,p=0.52)。第 5 天,T 组完成所有任务的参与者明显多于 NT 组(100%比 63%,p=0.008)。T 组参与者在第 5 天的任务完成时间较第 1 天明显提高(p<0.05)。NT 组第 5 天第 1 项任务的任务完成时间较第 1 天明显提高(p=0.037);第 2 项和第 3 项任务没有差异。第 5 天,T 组与 NT 组相比,所需的入路变更次数明显减少(2.35±2.29 比 6.95±8.55,p=0.039)。

结论

在简单、低成本的关节镜三角训练系统上进行模拟训练,在 1 周的训练内,整体上提高了关节镜探查和三角测量技能,显著缩短了任务完成时间,提高了运动效率。

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