Division of Vascular and Endovascular Surgery, Louisiana State University Health Sciences Center, 433 Bolivar Street, New Orleans, LA 70112.
Division of Vascular and Endovascular Surgery, Louisiana State University Health Sciences Center, 433 Bolivar Street, New Orleans, LA 70112.
Semin Vasc Surg. 2019 Mar-Jun;32(1-2):48-67. doi: 10.1053/j.semvascsurg.2018.12.006. Epub 2019 Jan 4.
The evolving demands of surgical training have led to the successful implementation of skills examinations in the areas of laparoscopic and endoscopic surgery. Currently, there is no similar formal skills assessment in vascular surgery, despite endovascular intervention replacing open surgery in treatment of many vascular conditions. The adoption of less invasive techniques to treat aneurysm and occlusive disease has resulted in new training paradigms and technical challenges for trainees. The duty hour restriction for trainees and declining numbers of complex open vascular interventions have added to the challenges of vascular surgery training. Simulation is a promising avenue for both skills training and assessment. The ability to evaluate the fundamental skills of trainees would be an important step to ensure a degree of uniformity in trainees' technical abilities. The role of simulation-based training in acquiring, testing, and refining these skills is still in its infancy in the vascular surgery training paradigm. This article aims to impart a deeper understanding of the conditions for developing and implementing the fundamentals of vascular and endovascular surgery, and to provide guidance regarding the role of simulation-based training in a rapidly evolving specialty. There are various forms of simulation available, including benchtop models, high-fidelity simulators, and virtual-reality simulators, and each requires a different method of proficiency assessment. Both open surgery and endovascular skills can be assessed and the application of successful implementation in academic vascular surgery training program is presented.
外科培训需求的不断发展，使得腹腔镜和内镜手术领域的技能考试得以成功实施。尽管血管腔内介入治疗已取代开放手术成为许多血管疾病的治疗方法，但目前血管外科尚无类似的正式技能评估。采用微创技术治疗动脉瘤和闭塞性疾病，为受训者带来了新的培训模式和技术挑战。受训者的工作时间限制以及复杂的开放血管介入手术数量的减少，增加了血管外科培训的难度。模拟是技能培训和评估的一个有前途的途径。评估受训者基本技能的能力，对于确保受训者技术能力的一定程度的一致性是非常重要的。基于模拟的培训在获取、测试和完善这些技能方面的作用，在血管外科培训模式中仍处于起步阶段。本文旨在深入了解开发和实施血管和血管内外科基本技能的条件，并就基于模拟的培训在快速发展的专业中的作用提供指导。有多种形式的模拟可供选择，包括台式模型、高保真模拟器和虚拟现实模拟器，每种模拟器都需要不同的熟练程度评估方法。可以评估开放手术和血管腔内技能，并且展示了其在学术血管外科培训计划中的成功实施。
