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基于模拟的开放性血管外科手术教育中的学员体验。

Trainee Experience in Simulation-Based Education of Open Vascular Surgery.

机构信息

Division of Vascular Surgery, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA.

Division of Vascular Surgery, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA.

出版信息

Ann Vasc Surg. 2021 May;73:147-154. doi: 10.1016/j.avsg.2020.11.026. Epub 2020 Dec 26.

Abstract

BACKGROUND

Simulation continues to be an important adjunct to vascular surgery training, yet the optimal implementation of simulation to complement conventional surgical training continues to evolve. This study aims to find areas for improvement in current simulation-based training of open vascular skills by characterizing the experience of vascular trainees attending a national simulation-based course.

METHOD

This was a survey study conducted at the simulation course of the Annual UCLA/SVS Symposium: A Comprehensive Review and Update of What's New in Vascular and Endovascular Surgery, a national vascular surgery meeting. The survey consisted of 17 questions and was administered on paper or electronically via the Audience Response System, before the start of the course. The survey assessed the participants' experience in formal training, simulation training, and comfort with open surgical procedures.

RESULTS

Between 2013 and 2018, the survey was completed by 150 participants of which 65% were vascular fellows. Only 48% of the participants had formal training in suturing and surgical instruments. Most participants had formal training in basic vascular techniques and advanced vascular operations. In 71%, simulation was incorporated into basic technique training and 60% in open surgical training. Simulation training was most commonly utilized in learning anastomotic techniques and open abdominal aortic aneurysm repair. Simulation skills were deemed translatable to the operating room by 59% of participants. Most participants were comfortable performing open vascular procedures. However, 68% of participants were uncomfortable performing an abdominal aortic aneurysm repair.

CONCLUSIONS

There continues to be a significant portion of trainees who do not undergo a simulation-based education. Current simulation training is being targeted to meet trainee needs in open vascular surgery, specifically open aneurysm repair. Nonetheless, trainees continue to have doubts regarding applicability of simulation-based skills to the operating theater. Further studies investigating access to simulation education as well as its translatability are needed.

摘要

背景

模拟仍然是血管外科学培训的重要辅助手段,但模拟与传统手术培训相结合的最佳实施方式仍在不断发展。本研究旨在通过描述参加全国模拟课程的血管外科受训者的经验,找出当前基于模拟的开放血管技能培训中需要改进的地方。

方法

这是一项在 UCLA/SVS 年会模拟课程中进行的调查研究:血管和血管外科学的最新综合回顾和更新,这是一个全国性的血管外科学会议。该调查包括 17 个问题,在课程开始前以纸质或电子方式通过观众响应系统进行。该调查评估了参与者在正式培训、模拟培训和开放手术程序方面的经验。

结果

在 2013 年至 2018 年期间,共有 150 名参与者完成了调查,其中 65%是血管研究员。只有 48%的参与者接受过缝合和手术器械的正式培训。大多数参与者接受过基本血管技术和高级血管手术的正式培训。71%的人将模拟纳入基本技术培训,60%的人将模拟纳入开放手术培训。模拟培训最常用于学习吻合技术和开放腹主动脉瘤修复。59%的参与者认为模拟技能可以转化到手术室。大多数参与者对进行开放血管手术感到舒适。然而,68%的参与者对进行腹主动脉瘤修复感到不舒服。

结论

仍有相当一部分受训者没有接受基于模拟的教育。目前的模拟培训旨在满足受训者在开放血管手术方面的需求,特别是开放动脉瘤修复。尽管如此,受训者仍然对模拟技能在手术室中的应用存在疑问。需要进一步研究调查获得模拟教育的机会及其可转移性。

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