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[虚拟关节镜检查:未来的游戏还是训练概念]

[Virtual arthroscopy : Gaming or training concept of the future].

作者信息

Reppenhagen Stephan, Weißenberger Manuel, Barthel Thomas, Rudert Maximilian, Anetzberger Hermann

机构信息

Orthopädische Klinik König-Ludwig-Haus, Lehrstuhl für Orthopädie, Julius-Maximilians-Universität, Brettreichstr. 11, 97074, Würzburg, Deutschland.

Orthopädische Gemeinschaftspraxis am OEZ, München, Deutschland.

出版信息

Unfallchirurg. 2019 Jun;122(6):431-438. doi: 10.1007/s00113-019-0653-5.

DOI:10.1007/s00113-019-0653-5
PMID:31065737
Abstract

Arthroscopy is a technically challenging surgical procedure with a relatively shallow learning curve compared to open procedures. To become an expert special cognitive and manual abilities have to be acquired and trained. The current situation in further medical education combined with the increasing economic pressure in the medical field does not leave enough room for a time-consuming training in arthroscopic techniques. A structured simulation training could be an alternative solution to this problem. The benefits of arthroscopic simulation training are meanwhile well documented. The complex tasks that an expert carries out during arthroscopy can be fragmented into more simple and elementary exercises and can be trained in a stress-free environment outside the operation room. An essential advantage of simulation training is the assessment of objective measurement parameters during the individual exercises. These parameters can be used to evaluate the learning process and performance of arthroscopic tasks. The aim of this review is to reflect the current state of simulation technology in arthroscopy and to show how simulator training can be meaningfully and effectively integrated into arthroscopic further training, exemplified by a modern medical further education concept.

摘要

与开放手术相比,关节镜检查是一项技术要求高的外科手术,其学习曲线相对较浅。要成为专家,必须具备并训练特殊的认知和手动能力。当前医学继续教育的现状,再加上医疗领域日益增加的经济压力,没有为关节镜技术的耗时训练留出足够空间。结构化模拟训练可能是解决这一问题的替代方案。与此同时,关节镜模拟训练的益处已有充分记录。专家在关节镜检查过程中执行的复杂任务可以分解为更简单、基本的练习,并可以在手术室之外无压力的环境中进行训练。模拟训练的一个重要优势是在各个练习过程中评估客观测量参数。这些参数可用于评估关节镜任务的学习过程和表现。本综述的目的是反映关节镜检查中模拟技术的当前状态,并展示模拟器训练如何以现代医学继续教育概念为例,有意义且有效地融入关节镜继续训练中。

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本文引用的文献

1
The Role of Arthroscopic Simulation in Teaching Surgical Skills: A Systematic Review of the Literature.关节镜模拟在手术技能教学中的作用:文献系统综述
JBJS Rev. 2018 Sep;6(9):e8. doi: 10.2106/JBJS.RVW.17.00201.
2
Editorial Commentary: Proficiency-Based Training: Are We Ready for a New Way to Train and Test Orthopaedic Surgeons?社论评论:基于能力的培训:我们是否准备好采用新的方式来培训和考核骨科医生?
Arthroscopy. 2018 Jul;34(7):2199-2200. doi: 10.1016/j.arthro.2018.04.006.
3
Does virtual reality simulation have a role in training trauma and orthopaedic surgeons?
虚拟现实模拟在创伤和骨科医生培训中有作用吗?
Bone Joint J. 2018 May 1;100-B(5):559-565. doi: 10.1302/0301-620X.100B5.BJJ-2017-1439.
4
Knee, Shoulder, and Fundamentals of Arthroscopic Surgery Training: Validation of a Virtual Arthroscopy Simulator.膝关节、肩关节及关节镜手术培训基础:虚拟关节镜模拟器的验证
Arthroscopy. 2017 Mar;33(3):641-646.e3. doi: 10.1016/j.arthro.2016.09.014. Epub 2016 Dec 16.
5
Comparison of Three Virtual Reality Arthroscopic Simulators as Part of an Orthopedic Residency Educational Curriculum.作为骨科住院医师教育课程一部分的三种虚拟现实关节镜模拟器的比较
Iowa Orthop J. 2016;36:20-5.
6
Learning Curves in Arthroplasty in Orthopedic Trainees.骨科住院医师关节置换术的学习曲线
J Surg Educ. 2016 Jul-Aug;73(4):689-93. doi: 10.1016/j.jsurg.2016.02.006. Epub 2016 May 8.
7
Simulation Training Improves Surgical Proficiency and Safety During Diagnostic Shoulder Arthroscopy Performed by Residents.模拟训练可提高住院医师在诊断性肩关节镜检查中的手术熟练度和安全性。
Orthopedics. 2016 May 1;39(3):e479-85. doi: 10.3928/01477447-20160427-02. Epub 2016 May 2.
8
Validation of the updated ArthroS simulator: face and construct validity of a passive haptic virtual reality simulator with novel performance metrics.更新后的关节镜模拟器的验证:具有新型性能指标的被动触觉虚拟现实模拟器的表面效度和结构效度
Knee Surg Sports Traumatol Arthrosc. 2017 Feb;25(2):616-625. doi: 10.1007/s00167-016-4114-1. Epub 2016 Apr 16.
9
Validation of a virtual reality-based simulator for shoulder arthroscopy.基于虚拟现实的肩关节镜模拟器的验证
Knee Surg Sports Traumatol Arthrosc. 2016 May;24(5):1730-7. doi: 10.1007/s00167-016-4022-4. Epub 2016 Feb 9.
10
Effectiveness of Virtual Reality Training in Orthopaedic Surgery.虚拟现实训练在骨科手术中的有效性。
Arthroscopy. 2016 Jan;32(1):224-32. doi: 10.1016/j.arthro.2015.07.023. Epub 2015 Sep 26.