Ahmad Karam, Bhattacharyya Rahul, Gupte Chinmay
MSk Lab, Imperial College London, 2nd Floor, Sir Michael Uren Hub, 86 Wood Lane, London W12 0BZ, UK.
Ann Med Surg (Lond). 2020 Nov;59:131-137. doi: 10.1016/j.amsu.2020.09.031. Epub 2020 Sep 23.
Working time restraints; senior led care; and a reduction in 'out of hours' operating has resulted in less operating time for orthopaedic trainees in the United Kingdom. Therefore, there has been an attempt to overcome these challenges by implementing novel techniques. Cognitive Task Analysis (CTA) focuses on the mental steps required to complete complex procedures. It has been used in training athletes and in general surgery but is new to orthopaedic training.
To undertake a systematic review to analyse if CTA is beneficial to train novice surgeons in common orthopaedic and trauma procedures.
A systematic review was performed evaluating CTA in trauma and orthopaedic surgery on MEDLINE and EMBASE. Search terms used were: 'Cognitive task', 'mental rehearsal' and 'Orthop*'']. 33 studies were originally identified. Duplicate studies were excluded (11). Articles not relating to Orthopaedic surgery were excluded (15). The CTA research ranking scale was used to evaluate the impact of the studies included.
7 studies were identified as appropriate for inclusion. 264 participants. 178 M, 86F. All studies showed objective or subjective benefits from CTA in orthopaedic training when compared to traditional methods. The majority of the participants highlighted high subjective satisfaction with the use of the CTA tools and reported that they proved to be excellent adjuncts to the traditional apprenticeship model.
CTA learning tools have demonstrated significant objective and subjective benefits in trauma and orthopaedic training. It is cost effective, easily accessible and allows repeated practice which is key in simulation training.
工作时间限制、高级医师主导的护理以及“非工作时间”手术量的减少，导致英国骨科住院医师的手术时间减少。因此，人们试图通过采用新技术来克服这些挑战。认知任务分析（CTA）关注完成复杂手术所需的思维步骤。它已被用于运动员训练和普通外科手术，但在骨科训练中尚属首次。
进行一项系统评价，分析CTA是否有利于培训新手外科医生进行常见的骨科和创伤手术。
在MEDLINE和EMBASE上对CTA在创伤和骨科手术中的应用进行了系统评价。使用的检索词为：“认知任务”、“心理预演”和“Orthop*”。最初识别出33项研究。排除重复研究（11项）。排除与骨科手术无关的文章（15项）。使用CTA研究排名量表评估纳入研究的影响。
确定7项研究适合纳入。共264名参与者，其中男性178名，女性86名。与传统方法相比，所有研究均表明CTA在骨科训练中具有客观或主观益处。大多数参与者对CTA工具的使用表示高度主观满意，并报告称这些工具被证明是传统学徒模式的优秀辅助手段。
CTA学习工具在创伤和骨科训练中已显示出显著的客观和主观益处。它具有成本效益、易于获取，并允许重复练习，这是模拟训练的关键。
