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新型经尿道前列腺切除术(TURP)教学课程的设计、实施和评估:泌尿外科模拟训练营课程的 3 年经验。

Design, implementation, and evaluation of a novel curriculum to teach transurethral resection of the prostate (TURP): a 3-year experience of urology simulation bootcamp course.

机构信息

Birmingham Heartlands Hospital, Birmingham, UK.

Leicester General Hospital, Leicester, UK.

出版信息

World J Urol. 2020 Nov;38(11):2899-2906. doi: 10.1007/s00345-020-03104-3. Epub 2020 Feb 10.

Abstract

OBJECTIVES

To present the three-year experience of the multi-component TURP module at Urology Simulation Bootcamp Course (USBC) and demonstrate trainee's competence progression and satisfaction.

METHODS

During the USBC, a 4-h TURP module was developed and consisted of (a) familiarisation and assembly of resectoscope instrument, (b) didactic lecture on TURP operative techniques and postoperative complications, (c) learning hands-on resection on validated simulators [Samed, GmBH, Dresden, Germany; TURP Mentor™, Simbionix, Israel], and (d) practicing clot evacuation using the Ellik bladder Evacuator. Trainee's level of instrument knowledge, operative competence, and confidence were assessed pre- and post-course. Trainee's feedback was also collected.

RESULTS

One hundred thirty trainees participated in the USBC between 2016 and 2018. Eighty-seven percent of trainees scored themselves as 1-3 (low confidence in resection) on a 5-point Likert scale. Trainees significantly improved in their ability to perform resectoscope assembly for resection, coagulation and incision by 33.6% (p < 0.001), 28.1% (p < 0.001) and 34.0% (p < 0.001), respectively. There was a significant improvement in scores in itemised technical skill on the TURP simulator following completion of the TURP module (Mean difference = 3.4 points, 95% CI 2-4, p < 0.001). Ninety-one percent of trainees agreed that the TURP module was useful for their development in urological training.

CONCLUSION

Our results demonstrated that it is feasible to develop and implement a focussed module for teaching TURP with significant improvement in learning. Trainee feedback suggests that they were highly satisfied with the teaching provided and models used. This style of training can be implemented for other common surgical procedures.

摘要

目的

介绍泌尿外科模拟训练营(Urology Simulation Bootcamp Course,USBC)中多组件 TURP 模块的三年经验,并展示学员的能力进展和满意度。

方法

在 USBC 期间,开发了一个 4 小时的 TURP 模块,包括(a)熟悉和组装电切镜仪器,(b)关于 TURP 手术技术和术后并发症的讲座,(c)在经过验证的模拟器[德国德累斯顿的 Samed,GmbH;以色列的 TURP Mentor™,Simbionix]上进行实际切除操作,以及(d)使用 Ellik 膀胱抽吸器进行血块清除练习。在课程前后评估学员的仪器知识、手术能力和信心水平。还收集了学员的反馈。

结果

2016 年至 2018 年期间,有 130 名学员参加了 USBC。87%的学员在 5 分制的 Likert 量表上给自己的切除信心评分在 1-3 分(低切除信心)。学员在进行切除、凝固和切割的电切镜组装能力方面有显著提高,分别提高了 33.6%(p<0.001)、28.1%(p<0.001)和 34.0%(p<0.001)。完成 TURP 模块后,TURP 模拟器上的各项技术技能评分均有显著提高(平均差值为 3.4 分,95%CI 2-4,p<0.001)。91%的学员认为 TURP 模块对他们的泌尿科培训发展很有用。

结论

我们的结果表明,开发和实施聚焦于 TURP 教学的模块是可行的,并且可以显著提高学习效果。学员的反馈表明,他们对所提供的教学和使用的模型非常满意。这种培训方式可以用于其他常见的手术程序。

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