Zhao Jiawei, Ahmad Meleha, Gower Emily W, Fu Roxana, Woreta Fasika A, Merbs Shannath L
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Gillings School of Global Public Health and Department of Ophthalmology, University of North Carolina, Chapel Hill, NC, USA.
BMC Med Educ. 2021 Mar 19;21(1):170. doi: 10.1186/s12909-021-02600-3.
Repair of margin-involving eyelid lacerations is a challenge for beginning ophthalmology residents, yet no commercially-available simulation models exist for learning this skill. The objective of the study was to modify a mannequin-based surgical simulator originally developed for trachomatous trichiasis surgery training to teach margin-involving eyelid laceration repair and to evaluate its success within a residency wet-lab environment.
We modified a previously developed mannequin-based training system for trachomatous trichiasis surgery into a simulator for margin-involving eyelid laceration repair. Six ophthalmology residents from a tertiary care academic institution performed at least one simulated margin-involving eyelid laceration repair using the surgical simulator between September 2019 and March 2020. Each session was video recorded. Two oculoplastic surgeons reviewed the videos in a blinded fashion to assess surgical proficiency using a standardized grading system. Participants were surveyed on their comfort level with eyelid laceration repair pre- and post-completion of simulation. They were also queried on their perceived usefulness of the surgical simulator compared to past methods and experiences.
Six residents completed 11 simulation surgeries. For three residents who completed more than one session, a slight increase in their skills assessment score and a decrease in operative time over two to three simulation sessions were found. Self-reported comfort level with margin-involving eyelid laceration repairs was significantly higher post-simulation compared to pre-simulation (p = 0.02). Residents ranked the usefulness of our surgical simulator higher than past methods such as fruit peels, surgical skill boards, gloves, and pig feet (p = 0.03) but lower than operating room experience (p = 0.02). Residents perceived the surgical simulator to be as useful as cadaver head and emergency department/consult experience.
We developed a surgical simulator for teaching eyelid laceration repair and showed its utility in developing trainees' surgical skills. Our surgical simulator was rated to be as useful as a cadaver head but is more readily available and cost effective.
对于初入眼科的住院医师而言，修复累及睑缘的眼睑裂伤是一项挑战，然而目前尚无用于学习该技能的商用模拟模型。本研究的目的是对最初为沙眼性倒睫手术训练而开发的基于人体模型的手术模拟器进行改进，以教授累及睑缘的眼睑裂伤修复，并在住院医师湿实验室环境中评估其效果。
我们将先前开发的用于沙眼性倒睫手术的基于人体模型的训练系统改造成用于累及睑缘的眼睑裂伤修复的模拟器。2019年9月至2020年3月期间，来自一家三级医疗学术机构的6名眼科住院医师使用该手术模拟器至少进行了一次模拟累及睑缘的眼睑裂伤修复。每次操作均进行视频记录。两名眼整形外科医生以盲法观看视频，使用标准化评分系统评估手术熟练程度。在模拟前后，对参与者进行关于他们对眼睑裂伤修复的舒适度的调查。还询问了他们与过去的方法和经验相比，对手术模拟器的有用性的看法。
6名住院医师完成了11次模拟手术。对于完成超过一次操作的3名住院医师，发现在两到三次模拟操作中，他们的技能评估得分略有提高，手术时间有所缩短。与模拟前相比，模拟后自我报告的对累及睑缘的眼睑裂伤修复的舒适度显著更高（p = 0.02）。住院医师对我们手术模拟器有用性的排名高于过去的方法，如水果皮、手术技能板、手套和猪蹄（p = 0.03），但低于手术室经验（p = 0.02）。住院医师认为手术模拟器与尸体头部以及急诊科/会诊经验一样有用。
我们开发了一种用于教授眼睑裂伤修复的手术模拟器，并展示了其在培养学员手术技能方面的效用。我们的手术模拟器被评为与尸体头部一样有用，但更易于获得且成本效益更高。
