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多中心高级儿科耳鼻喉科奖学金预备外科模拟课程,使用 3D 打印高保真模型。

Multicenter Advanced Pediatric Otolaryngology Fellowship Prep Surgical Simulation Course with 3D Printed High-Fidelity Models.

机构信息

University of Michigan Medical School, Ann Arbor, Michigan, USA.

Department of Otolaryngology Head and Neck Surgery, Ann Arbor, Michigan, USA.

出版信息

Otolaryngol Head Neck Surg. 2020 May;162(5):658-665. doi: 10.1177/0194599820913003. Epub 2020 Apr 14.

Abstract

OBJECTIVE

To assess the effect of 3-dimensional (3D)-printed surgical simulators used in an advanced pediatric otolaryngology fellowship preparatory course on trainee education.

STUDY DESIGN

Quasi-experimental pre/postsurvey.

SETTING

Multicenter collaborative course conducted at a contract research organization prior to a national conference.

SUBJECTS AND METHODS

A 5-station, 7-simulator prep course was piloted for 9 pediatric otolaryngology fellows and 17 otolaryngology senior residents, with simulators for airway graft carving, microtia ear framework carving, and cleft lip/palate repair. Prior to the course, trainees were provided educational materials electronically along with presurveys rating confidence, expertise, and attitude around surgical simulators. In October 2018, surgeons engaged in simulation stations with direction from 2 attending faculty per station, then completed postsurveys for each simulator.

RESULTS

Statistically significant increases ( < .05) in self-reported confidence (average, 53%; range, 18%-80%) and expertise (average, 68%; range, 9%-95%) were seen across all simulators, corresponding to medium to large effect sizes as measured by Cohen's statistic (0.41-1.71). Positive attitudes around 3D printing in surgical education also demonstrated statistically significant increases (average, 10%; range, 8%-13%). Trainees commented positively on gaining such broad exposure, although consistently indicated a preference for more practice time during the course.

CONCLUSION

We demonstrate the benefit of high-fidelity, 3D-printed simulators in exposing trainees to advanced procedures, allowing them hands-on practice in a zero-risk environment. In the future, we hope to refine this course design, develop standardized tools to assess their educational value, and explore opportunities for integration into use in milestone assessment and accreditation.

摘要

目的

评估在高级儿科耳鼻喉科住院医师预备课程中使用三维(3D)打印手术模拟器对学员教育的影响。

研究设计

准实验前后调查。

设置

在全国会议前在合同研究组织进行的多中心协作课程。

受试者和方法

一项 5 站 7 模拟器预备课程为 9 名儿科耳鼻喉科住院医师和 17 名耳鼻喉科高级住院医师进行了试点,模拟器用于气道移植物雕刻、小耳框架雕刻和唇裂/腭裂修复。在课程开始前,学员通过电子方式获得教育材料,并在课程开始前进行调查,评估他们对手术模拟器的信心、专业知识和态度。2018 年 10 月,外科医生在 2 名主治教员的指导下在模拟站进行操作,然后完成每个模拟器的后续调查。

结果

所有模拟器的自我报告信心(平均 53%,范围 18%-80%)和专业知识(平均 68%,范围 9%-95%)均有统计学显著增加(<.05),对应于中等至大效应大小,由 Cohen's 统计量(0.41-1.71)测量。围绕手术教育中 3D 打印的积极态度也显示出统计学上的显著增加(平均 10%,范围 8%-13%)。学员对获得如此广泛的体验给予了积极评价,尽管他们一直表示希望在课程中获得更多的实践时间。

结论

我们证明了高保真 3D 打印模拟器在使学员接触先进手术方面的益处,使他们能够在零风险环境中进行实际操作。在未来,我们希望改进这一课程设计,开发标准化工具来评估其教育价值,并探索将其纳入里程碑评估和认证的机会。

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