Medical School, University of Michigan, Ann Arbor.
Otolaryngology-Head and Neck Surgery, Pediatric Division, University of Michigan Health Systems, CS Mott Children's Hospital, Ann Arbor.
JAMA Facial Plast Surg. 2019 Jul 1;21(4):327-331. doi: 10.1001/jamafacial.2019.0050.
Facial flap procedures may be difficult for surgical trainees to conceptualize and challenging for supervising surgeons to allow entrustment early in training. Simulation outside of the operating room may accelerate and enhance the surgical education experience.
To design and manufacture a 3-dimensional (3-D)-printed, multilayer, anatomically accurate facial flap model for use in surgical education.
DESIGN, SETTING, AND PARTICIPANTS: In this multicenter validation study, a 3-D-printed facial flap simulator was designed from a computed tomographic (CT) scan and manufactured for low-cost, high-fidelity simulation. Expert otolaryngology-head and neck surgeon feedback was acquired through surgical rehearsal and performance of 8 local facial flap procedures on the facial flap simulator by 7 otolaryngologists fellowship trained in facial plastic surgery.
Likert scale surveys were made based on evaluation criteria categorized into domains of realism, experience, and applicability of the simulator. Measures of central tendency, variability, and confidence intervals were generated to evaluate the outcomes.
Seven expert otolaryngology-head and neck surgeons completed a Likert scale evaluation survey containing quantitative analysis of 6 questions on physical attributes, 12 questions on realism, 8 questions on experience, and 4 questions on the applicability of the simulator. All expert surgeons were additionally fellowship trained in facial plastic surgery with their mean years in practice being 11.9. Overall evaluation demonstrated valuable ability of the simulator for medical education with suggestions for future directions. Importantly, the simulator was rated on a scale of 1 (no value) to 4 (great value) as 3.86 as a training tool, 3.57 as a competency evaluation tool, and 3.43 as a rehearsal tool.
Expert experience with the local facial flap simulator was rated highly for realism, experience, performance, and usefulness. With slight refinement, the model has strong potential for broad use in training in otolaryngology-head and neck surgery and facial plastic surgery.
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面部皮瓣手术对于外科受训者来说可能难以理解，对于监督外科医生来说，在培训早期允许委托也具有挑战性。手术室外的模拟可能会加速和增强手术教育体验。
设计和制造一种 3 维（3-D）打印的、多层的、解剖学上准确的面部皮瓣模型，用于外科教育。
设计、设置和参与者：在这项多中心验证研究中，从计算机断层扫描（CT）扫描设计了一种 3-D 打印的面部皮瓣模拟器，并为低成本、高保真模拟制造了该模拟器。通过 7 名接受过面部整形手术培训的耳鼻喉科研究员在面部皮瓣模拟器上进行 8 次局部面部皮瓣手术的手术排练和表现，获得了专家耳鼻喉科-头颈外科医生的反馈。
根据分为模拟现实性、经验和适用性领域的评估标准，进行了李克特量表调查。生成了集中趋势、变异性和置信区间的度量来评估结果。
7 名耳鼻喉科-头颈外科专家完成了一份李克特量表评估调查，其中包含对物理属性的 6 个问题、对现实性的 12 个问题、对经验的 8 个问题和对模拟器适用性的 4 个问题进行的定量分析。所有专家外科医生都额外接受过面部整形手术的专业培训，他们的平均从业年限为 11.9 年。总体评估表明，模拟器在医学教育方面具有宝贵的能力，并提出了未来的发展方向。重要的是，模拟器的评分范围从 1（无价值）到 4（非常有价值），作为培训工具为 3.86，作为能力评估工具为 3.57，作为排练工具为 3.43。
专家对局部面部皮瓣模拟器的经验因其现实性、经验、性能和实用性而得到高度评价。稍加改进，该模型在耳鼻喉科-头颈外科和面部整形手术培训中具有广泛应用的强大潜力。
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