Department of Pediatric Surgery, Radboudumc, Nijmegen, The Netherlands.
Department of Pediatric Surgery, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Eur J Pediatr Surg. 2022 Jun;32(3):287-293. doi: 10.1055/s-0041-1723035. Epub 2021 Feb 10.
An anorectal malformation (ARM) is a congenital malformation that requires surgical correction. To acquire the skills needed to perform this complex procedure, an affordable simulation model has previously been developed and validated. The aim of this study is to evaluate the suitability of this ARM model (with perineal fistula) for training in hands-on workshops.
The ARM model consists of a wooden casing with disposable perineal body. Participants in several international pediatric colorectal hands-on workshops in 2019 and 2020 were asked to participate. They were divided in a target group and an experienced group based on experience. All practiced the posterior sagittal anorectoplasty procedure on the model with multimodality guidance. Subsequently, statements on the suitability of the model for use during hands-on workshops were scored on a 5-point Likert scale.
A total of 80 participants were included (43 surgical specialists, 13 pediatric surgery fellows, and 25 residents). Nearly, all statements scored at least a mean of >4.0, all scored significantly better than a neutral opinion. The target group ( = 58) scored higher compared with the experienced group ( = 22) on "transferability of the skills to the clinical setting" (means 4.4 vs. 4.0, = 0.038); however, the "suitability as a replacement for an animal model" scored significantly lower (means 3.6 vs. 3.9, = 0.049). No other differences were found.
This affordable ARM model was regarded a suitable model for training during preclinical hands-on workshops and could be used for the specified steps of the procedure.
肛门直肠畸形（ARM）是一种先天性畸形，需要手术矫正。为了获得执行这种复杂手术所需的技能，之前已经开发并验证了一种负担得起的模拟模型。本研究旨在评估这种具有会阴瘘的 ARM 模型（肛门直肠畸形）在实践工作坊培训中的适用性。
ARM 模型由一个带有一次性会阴体的木制外壳组成。2019 年和 2020 年，邀请参加了几次国际小儿肛肠实践工作坊的参与者参加。根据经验，他们被分为目标组和经验丰富的组。所有参与者都在模型上使用多模态指导练习了后路矢状位肛门直肠成形术。随后，参与者对模型在实践工作坊中的适用性进行了 5 分制 Likert 评分。
共纳入 80 名参与者（43 名外科专家、13 名小儿外科研究员和 25 名住院医师）。几乎所有陈述的评分都至少为>4.0，均明显优于中立意见。目标组（ = 58）在“将技能转移到临床环境中的能力”方面的评分明显高于经验丰富的组（ = 22）（平均值 4.4 与 4.0， = 0.038）；然而，“作为动物模型的替代品的适用性”的评分明显较低（平均值 3.6 与 3.9， = 0.049）。未发现其他差异。
这种负担得起的 ARM 模型被认为是临床前实践工作坊培训的合适模型，可用于该手术的指定步骤。
