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手术模拟器训练可减少住院医师学习白内障超声乳化手术的手术时间。

Surgical simulator training reduces operative times in resident surgeons learning phacoemulsification cataract surgery.

作者信息

Lopez-Beauchamp Cristina, Singh Gemini A, Shin Soo Y, Magone M Teresa

机构信息

Veterans Affairs Medical Center, Department of Surgery /Ophthalmology Section, 50 Irving Street NW, Washington, DC, 20422, USA.

Howard University Hospital, Ophthalmology Department, Tower Building, 2041 Georgia Avenue NW, #2100, Washington, DC, 20060, USA.

出版信息

Am J Ophthalmol Case Rep. 2019 Dec 9;17:100576. doi: 10.1016/j.ajoc.2019.100576. eCollection 2020 Mar.

Abstract

PURPOSE

To compare the surgical duration for routine phacoemulsification surgeries in residents with and without virtual simulator training.

METHODS

Retrospective cohort study of operative times of routine phacoemulsification cataract surgeries performed by 29 different third-year residents rotating at one academic institution. One group underwent mandatory virtual cataract surgery simulator training (SIM) in their second year of residency before starting surgeries while the other group did not undergo any simulator training (NOSIM). Outcomes measured were comparative surgical times and vitreous loss rates between groups in their third year of residency.

RESULTS

722 surgeries were included. Surgeries in the SIM group were on average 6.7 min (min) shorter compared to the NOSIM group (P = 0.0001). Although both groups required less time for surgery over the course of the academic year, regression analysis showed that NOSIM group residents overall required 17% longer time for an uncomplicated clear corneal phacoemulsification surgery (incidence rate ratio 1.17; p = 0.0001). In the final month of their residency residents in the SIM group (32.2 ± 3 min) were 9 min faster than NOSIM peers (41.2 ± 3 min mean ± SE; p = 0.02). Vitreous loss rates were 1.4% in the SIM group and 3.6% in the NOSIM group (p = 0.06).

CONCLUSION AND IMPORTANCE

Early and continuous implementation of mandatory virtual simulator surgical training before starting intraocular surgeries significantly decreases operative times in third year residents learning phacoemulsification compared to non-simulator trained peers.

摘要

目的

比较接受虚拟模拟器训练和未接受虚拟模拟器训练的住院医师进行常规超声乳化手术的手术时长。

方法

对在某学术机构轮转的29名不同的三年级住院医师进行的常规超声乳化白内障手术的手术时间进行回顾性队列研究。一组在住院医师培训的第二年开始手术前接受了强制性虚拟白内障手术模拟器训练(SIM组),而另一组未接受任何模拟器训练(NOSIM组)。测量的结果是两组在住院医师培训第三年的手术时间比较和玻璃体丢失率。

结果

共纳入722例手术。SIM组的手术平均比NOSIM组短6.7分钟(P = 0.0001)。尽管两组在学年期间的手术时间都有所减少,但回归分析显示,NOSIM组的住院医师总体上进行简单的透明角膜超声乳化手术所需时间长17%(发病率比1.17;P = 0.0001)。在住院医师培训的最后一个月,SIM组的住院医师(32.2±3分钟)比NOSIM组的同行快9分钟(平均±标准误为41.2±3分钟;P = 0.02)。SIM组的玻璃体丢失率为1.4%,NOSIM组为3.6%(P = 0.06)。

结论及意义

与未接受模拟器训练的同行相比,在开始眼内手术前尽早并持续实施强制性虚拟模拟器手术训练可显著缩短学习超声乳化的三年级住院医师的手术时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eeb8/6926105/485f7f933cb4/gr1.jpg

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