Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
World Neurosurg. 2019 Jul;127:63-71. doi: 10.1016/j.wneu.2019.03.230. Epub 2019 Mar 28.
An increasing body of literature describing use of high-fidelity surgical training models is challenging long-held dogma that cadavers provide the best medium for postgraduate surgical skills training. The purpose of this study was to describe a surgical skills course comprising entirely synthetic training models developed by resident and attending neurosurgeons and to evaluate their perceptions of the overall usefulness of this course and its usefulness compared with cadaveric courses.
Ten high-fidelity neurosurgical training models were developed. A neurosurgical skills course for residents was structured to include 7 spinal and 3 cranial learning stations, each with its own model and assigned attending expert. Resident and attending neurosurgeons were asked to complete surveys on their overall impressions of the course and models and on workload comparisons between models and real cases. Student t tests were used for statistical comparisons.
Survey responses were collected from 9 of 16 participating residents (56.3%) and 3 of 10 attending neurosurgeons (30.0%). Both groups believed that the course was very helpful overall to resident education. Respondents furthermore believed that the course was more helpful overall than cadaveric courses. Task load index testing showed no significant workload difference between models and real cases (P ≥ 0.17), except in temporal demand (P < 0.001).
Resident and attending neurosurgeons subjectively believe that high-fidelity synthetic models were superior to cadavers as a surgical skills teaching platform. This study raises the question of whether cadavers should remain the gold standard for surgical skills courses. Expanded use of these teaching models and further study are warranted.
越来越多的文献描述了使用高保真手术培训模型，这对长期以来认为尸体是研究生外科技能培训最佳媒介的观念提出了挑战。本研究的目的是描述一个完全由住院医生和主治神经外科医生开发的合成培训模型的外科技能课程，并评估他们对该课程的整体实用性及其与尸体课程相比的实用性的看法。
开发了 10 种高保真神经外科培训模型。为住院医生设计了一个神经外科技能课程，包括 7 个脊柱和 3 个颅腔学习站，每个学习站都有自己的模型和指定的主治专家。要求住院医生和主治神经外科医生填写关于课程和模型的总体印象以及模型与实际病例之间工作量比较的调查问卷。采用学生 t 检验进行统计比较。
从 16 名参与的住院医生中（56.3%）和 10 名主治神经外科医生中（30.0%）收集了调查答复。两个组都认为该课程对住院医生的教育非常有帮助。受访者还认为该课程比尸体课程总体上更有帮助。任务负荷指数测试显示模型与实际病例之间的工作量差异无统计学意义（P≥0.17），除了在时间需求方面（P<0.001）。
住院医生和主治神经外科医生主观上认为高保真合成模型作为外科技能教学平台优于尸体。本研究提出了一个问题，即尸体是否应继续作为外科技能课程的黄金标准。有必要扩大这些教学模型的使用并进一步研究。
