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美国外科各科室基于模拟的培训现状。

Status of Simulation-Based Training in Departments of Surgery in the United States.

作者信息

Schlottmann Francisco, Tolleson-Rinehart Sue, Kibbe Melina R, Patti Marco G

机构信息

Department of Surgery, University of North Carolina, Chapel Hill, North Carolina; Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina.

Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina.

出版信息

J Surg Res. 2020 Nov;255:158-163. doi: 10.1016/j.jss.2020.05.041. Epub 2020 Jun 17.

Abstract

BACKGROUND

Surgical simulation is particularly attractive because it allows training in a safe, controlled, and standardized environment. However, the status of surgical simulation among Departments of Surgery (DoS) in the United States is unknown. The objective of this study was to characterize the status of simulation-based training in DoS in the United States.

MATERIALS AND METHODS

A Qualtrics online survey was sent to 177 chairs of DoS in the United States in March 2018 regarding the utilization of surgical simulation in their department. Questions in the survey were focused on simulation capacities and activities as well as chairs' perception of the value and purpose of simulation.

RESULTS

A total of 87 of 177 chairs responded to the survey (49% response rate). Most programs had either 20-50 trainees (42 of 87; 48%) or more than 50 trainees (37 of 87; 43%). Most chairs reported having a simulation center in their institution (85 of 87; 98%) or department (60 of 86; 70%) with a formal simulation curriculum for their trainees (83 of 87; 95%). Ninety percent (78 of 87) of DoS had protected time for simulation education for their residents, with most residents engaging in activities weekly or monthly (65 of 85; 76%). Although most chairs felt simulation improves patient safety (72 of 84; 86%) and is useful for practicing surgeons (68 of 84; 81%), only 40% reported that faculty use simulation to maintain technical skills and only 17% reported that faculty use simulation to address high complication rates.

CONCLUSIONS

The vast majority of the DoS in the United States have established simulation activities for their trainees. However, engagement of faculty in simulation to maintain or improve their skills remains low.

摘要

背景

手术模拟极具吸引力,因为它能在安全、可控且标准化的环境中开展培训。然而,美国外科各科室(DoS)中手术模拟的现状尚不清楚。本研究的目的是描述美国外科各科室基于模拟的培训现状。

材料与方法

2018年3月,通过Qualtrics在线调查向美国177位外科科室主任发送了关于其所在科室手术模拟使用情况的问卷。调查问卷的问题聚焦于模拟能力与活动,以及科室主任对模拟价值和目的的看法。

结果

177位科室主任中有87位回复了调查(回复率为49%)。大多数项目有20 - 50名学员(87个项目中的42个;48%)或超过50名学员(87个项目中的37个;43%)。大多数科室主任报告称其所在机构(87个中的85个;98%)或科室(86个中的60个;70%)设有模拟中心,且为学员制定了正式的模拟课程(87个中的83个;95%)。90%(87个中的78个)的外科科室为住院医师提供了用于模拟教育的受保护时间,大多数住院医师每周或每月参与模拟活动(85个中的65个;76%)。尽管大多数科室主任认为模拟可提高患者安全性(84个中的72个;86%)且对执业外科医生有用(84个中的68个;81%),但只有40%报告称教员使用模拟来维持技术技能,只有17%报告称教员使用模拟来应对高并发症发生率。

结论

美国绝大多数外科科室已为其学员开展了模拟活动。然而,教员参与模拟以维持或提高其技能的程度仍然较低。

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