Experimental Surgery and Simulation Center, Division of Gastrointestinal Surgery, Pontificia Universidad Católica de Chile, Chile.
Experimental Surgery and Simulation Center, Division of Gastrointestinal Surgery, Pontificia Universidad Católica de Chile, Chile.
Injury. 2021 May;52(5):1215-1220. doi: 10.1016/j.injury.2020.12.004. Epub 2020 Dec 24.
. In the last decade, concern regarding the preparedness of general surgery graduates to effectively manage thoracic trauma cases has been raised. However, due to limited availability and elevated costs, access to cardiopulmonary trauma simulation models is limited. This article describes our experience implementing a low-cost blended ex vivo tissue-based simulation model using animal by-products that incorporates pump perfusion and ventilation.
. Firstly, for validation purposes 8 junior residents, 8 recently graduated general surgeons, and 3 cardiothoracic surgery attendings from Pontificia Universidad Católica de Chile Clinical Hospital were recruited. Proficiency in performing a pulmonary tractotomy and a myocardial injury repair was assessed with global and specific rating scales. Secondly, to evaluate the effectiveness of the model as a learning tool, 16 general surgery residents from different programs across the country were recruited receiving intensive, personalized training on the models. Proficiency was measured before and after the training.
. For the validation phase, significant differences among groups according to the previous level of expertise were shown, and therefore construct validity was established. The results of the second phase showed a significant overall improvement in participant's performance.
. Effective training and assessment for advanced surgical skills in cardiothoracic trauma can be achieved using a low-cost pulsatile simulation model.
在过去的十年中,人们对普通外科毕业生有效处理胸部创伤病例的准备情况表示关注。然而,由于可用性有限且成本高昂,心肺创伤模拟模型的获取受到限制。本文介绍了我们使用动物副产品实施低成本混合离体组织模拟模型的经验,该模型结合了泵灌注和通气。
首先,为了验证目的,我们招募了 8 名初级住院医师、8 名最近毕业的普通外科医生和 3 名来自智利天主教大学临床医院的心胸外科主治医生。使用全球和特定评分量表评估他们进行肺段切除术和心肌损伤修复的熟练程度。其次,为了评估该模型作为学习工具的有效性,我们招募了来自全国不同项目的 16 名普通外科住院医师,对他们进行模型的强化个性化培训。在培训前后测量熟练程度。
在验证阶段,根据先前的专业水平,不同组之间显示出显著差异,因此建立了结构有效性。第二阶段的结果显示,参与者的整体表现有显著提高。
使用低成本脉动模拟模型可以实现心胸创伤高级外科技能的有效培训和评估。