Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
J Surg Educ. 2019 Sep-Oct;76(5):1433-1439. doi: 10.1016/j.jsurg.2019.03.005. Epub 2019 Apr 8.
Surgical skill training is difficult due to limited resources and the associated risks in the clinical setting. There have been many studies that have looked at optimizing resident skill techniques out of the operating room to optimize intraoperative teaching. Specifically, as seen in spine surgery performing a laminectomy with a high-speed drill is difficult and requires many hours of training and guidance before a resident can feel comfortable to adequately complete the laminectomy with minimal risk of adverse effects.
The objective of this study is to assess if pre-education of residents prior to using the high-speed drill will significantly increase their comfort level, as well as increase the success of laminectomy.
DESIGN, SETTING AND PARTICIPANTS: This was done by a prospective cohort study in evaluating 20 orthopedic surgical residents via the objective structured assessment of technical skills and global rating scale.
Results showed that residents who had pre-education were in fact more successful in completing the laminectomy with the high-speed drill.
Pre-education, whether via a didactic or simulator-based model are both beneficial to resident's knowledge and surgical skill attainment however the simulator based model did not deem the group more successful in completing the laminectomy with the high-speed drill. Certain technical skills still require unreplaceable hands-on practice to become proficient.
由于临床环境中资源有限且相关风险较大，手术技能培训较为困难。已经有许多研究着眼于优化手术室外住院医师的技能技术，以优化术中教学。具体来说，在脊柱外科中，使用高速钻头进行椎板切除术非常困难，需要经过数小时的培训和指导，住院医师才能感到舒适并能够以最小的风险充分完成椎板切除术。
本研究旨在评估在使用高速钻头之前对住院医师进行预先教育是否会显著提高他们的舒适度，并增加椎板切除术的成功率。
设计、设置和参与者：这是一项前瞻性队列研究，通过客观结构化的技术技能评估和总体评估量表评估了 20 名骨科外科住院医师。
结果表明，接受预先教育的住院医师实际上更成功地完成了高速钻头的椎板切除术。
预先教育，无论是通过讲座还是基于模拟器的模型，都有利于住院医师的知识和手术技能的获得，但是基于模拟器的模型并没有使该组在使用高速钻头完成椎板切除术方面更成功。某些技术技能仍然需要不可替代的实践操作才能熟练掌握。
