Division of Surgery, CLINTEC, Karolinska Institutet, Stockholm, Sweden; Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Center for Advanced Medical Simulation and Training, Karolinska University Hospital, Stockholm, Sweden.
Center for Advanced Medical Simulation and Training, Karolinska University Hospital, Stockholm, Sweden; Division of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden.
J Surg Res. 2020 Jun;250:1-11. doi: 10.1016/j.jss.2019.12.039. Epub 2020 Jan 31.
Training using laparoscopic high-fidelity simulators (LHFSs) to proficiency levels improves laparoscopic cholecystectomy skills. However, high-cost simulators and their limited availability could negatively impact residents' laparoscopic training opportunities. We aimed to assess whether motivation and surgical skill performance differ after basic skills training (BST) using a low-cost (Blackbox) versus LHFS (LapMentor) among medical students.
Sixty-three medical students from Karolinska Institutet volunteered, completing written informed consent, questionnaire regarding expectations of the simulation training, and a visuospatial ability test. They were randomized into two groups that received BST using Blackbox (n = 32) or LapMentor (n = 31). However, seven students absence resulted in 56 participants, followed by another 9 dropouts. Subsequently, after training, 47 students took up three consecutive tests using the minimally invasive surgical trainer-virtual reality (MIST-VR) simulator, finalizing a questionnaire.
More Blackbox group participants completed all MIST-VR tests (29/31 versus 18/25). Students anticipated mastering LapMentor would be more difficult than Blackbox (P = 0.04). In those completing the simulation training, a trend toward an increase was noted in how well participants in the Blackbox group liked the simulator training (P = 0.07). Subgroup analysis of motivation and difficulty in liking the training regardless of simulator was found only in women (Blackbox [P = 0.02]; LapMentor [P = 0.06]). In the Blackbox group, the perceived difficulty of training, facilitation, and liking the Blackbox training (significant only in women) were significantly correlated with the students' performance in the MIST-simulator. No such correlations were found in the LapMentor group.
Results indicate an important role for low-tech/low-cost Blackbox laparoscopic BST of students in an otherwise high-tech surrounding. Furthermore, experience of Blackbox BST procedures correlate with students' performance in the MIST-VR simulator, with some gender-specific differences.
使用腹腔镜高保真模拟器（LHFS）进行熟练水平的培训可以提高腹腔镜胆囊切除术技能。然而，高成本的模拟器及其有限的可用性可能会对住院医师的腹腔镜培训机会产生负面影响。我们旨在评估在 Karolinska Institutet 进行的基本技能培训（BST）中，使用低成本（Blackbox）与 LHFS（LapMentor）相比，医学生的动机和手术技能表现是否存在差异。
63 名来自卡罗林斯卡学院的医学生自愿参加，完成书面知情同意书、关于模拟培训期望的调查问卷以及视空间能力测试。他们被随机分为两组，分别接受 Blackbox（n=32）或 LapMentor（n=31）的 BST。然而，由于 7 名学生缺席，最终有 56 名参与者，随后又有 9 名学生退出。随后，在培训后，47 名学生使用微创外科训练器虚拟现实（MIST-VR）模拟器连续进行了三次测试，最后完成了一份问卷。
更多的 Blackbox 组参与者完成了所有的 MIST-VR 测试（29/31 比 18/25）。学生们预计掌握 LapMentor 会比 Blackbox 更难（P=0.04）。在完成模拟培训的学生中，注意到 Blackbox 组学生对模拟器培训的喜爱程度有所提高（P=0.07）。无论模拟器如何，仅在女性中发现了动机和喜欢培训的难度的子组分析（Blackbox [P=0.02]；LapMentor [P=0.06]）。在 Blackbox 组中，培训的感知难度、促进和喜欢 Blackbox 培训（仅在女性中显著）与学生在 MIST-模拟器中的表现显著相关。在 LapMentor 组中没有发现这种相关性。
结果表明，在高科技环境中，使用低成本/低技术的 Blackbox 腹腔镜 BST 对学生具有重要作用。此外，Blackbox BST 程序的经验与学生在 MIST-VR 模拟器中的表现相关，存在一些性别特异性差异。
