Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
Department of Surgery, University of Cincinnati, Cincinnati, OH, USA.
Am J Surg. 2021 May;221(5):987-992. doi: 10.1016/j.amjsurg.2020.09.018. Epub 2020 Sep 18.
Surgical residencies have implemented boot-camps for early acquisition of basic technical skills for interns. However, educators worry that retention is poor. We hypothesized that a structured boot-camp curriculum would improve skills.
Interns underwent eight boot-camp sessions at the beginning of residency. Interns completed pre-, post-boot-camp, and end-of-year skills assessments, as well as post-boot camp and end-of-year porcine procedure labs. Proficiency was measured on a 5-point scale and by completion time.
After boot-camp, interns improved all domains of knot-tying. Median time decreased for skin-closure (8.3 vs 9.9 min, p < 0.01), peg transfer (57 vs 87 s, p < 0.01), intracorporeal (178 vs 300 s, p < 0.01), and extracorporeal knot-tying (140 vs 259 s, p < 0.01). At the end-of-year assessment, interns exhibited retention of all skills and improved in knot-tying and central line skills. During the retention porcine lab, interns progressed basic but not complex skills.
An eight-week boot-camp effectively improved technical skills among surgery interns. Interns retained all skills and improved upon techniques frequently practiced during intern year.
外科住院医师培训已经为实习医生实施了基础技术技能的速成班，以帮助他们尽早掌握这些技能。然而，教育工作者担心这种速成班的效果并不好，他们认为保留率不高。我们假设一个结构化的速成班课程可以提高技能。
实习医生在住院医师培训的开始阶段参加了八次速成班课程。实习医生在速成班前、速成班后和年终进行技能评估，以及速成班后和年终进行猪实验。熟练程度以 5 分制和完成时间来衡量。
速成班后，实习医生在所有结绳领域的技能都有所提高。皮肤缝合（8.3 分钟对 9.9 分钟，p<0.01）、钉转移（57 秒对 87 秒，p<0.01）、体腔内（178 秒对 300 秒，p<0.01）和体腔外结绳（140 秒对 259 秒，p<0.01）的时间中位数均减少。在年终评估中，实习医生保留了所有技能，并在结绳和中央线技能方面有所提高。在保留猪实验中，实习医生仅在基础技能上取得了进展，而在复杂技能上则没有进展。
八周速成班可以有效地提高外科实习医生的技术技能。实习医生保留了所有技能，并在实习年内经常练习的技术上有所提高。
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