Denton O, Daglish A, Smallman L, Fishpool S
Postgraduate Centre, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde, UK.
Postgraduate Medical Education Centre, Royal Berkshire NHS Foundation Trust, Reading, UK.
J Laryngol Otol. 2020 Jun;134(6):497-500. doi: 10.1017/S0022215120001188.
Rate of learning is often cited as a deterrent in the use of endoscopic ear surgery. This study investigated the learning curves of novice surgeons performing simulated ear surgery using either an endoscope or a microscope.
A prospective multi-site clinical research study was conducted. Seventy-two medical students were randomly allocated to the endoscope or microscope group, and performed 10 myringotomy and ventilation tube insertions. Trial times were used to produce learning curves. From these, slope (learning rate) and asymptote (optimal proficiency) were ascertained.
There was no significant difference between the learning curves (p = 0.41). The learning rate value was 68.62 for the microscope group and 78.71 for the endoscope group. The optimal proficiency (seconds) was 32.83 for the microscope group and 27.87 for the endoscope group.
The absence of a significant difference shows that the learning rates of each technique are statistically indistinguishable. This suggests that surgeons are not justified when citing 'steep learning curve' in arguments against the use of endoscopes in middle-ear surgery.
学习速度常被视为阻碍内镜耳科手术应用的因素。本研究调查了使用内镜或显微镜进行模拟耳科手术的新手外科医生的学习曲线。
开展了一项前瞻性多中心临床研究。72名医学生被随机分配至内镜组或显微镜组，进行10次鼓膜切开置管术。通过试验时间绘制学习曲线。据此确定斜率（学习率）和渐近线（最佳熟练程度）。
学习曲线之间无显著差异（p = 0.41）。显微镜组的学习率值为68.62，内镜组为78.71。显微镜组的最佳熟练程度（秒）为32.83，内镜组为27.87。
无显著差异表明，每种技术的学习率在统计学上无明显差异。这表明，外科医生在反对中耳手术中使用内镜的论点中提及“陡峭的学习曲线”是不合理的。
