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湿实验室培训与手术模拟器培训对眼科住院医师白内障手术劈核操作表现的效果比较

Efficacy of wet-lab training versus surgical-simulator training on performance of ophthalmology residents during chopping in cataract surgery.

作者信息

Hu Ya-Guang, Liu Qiu-Ping, Gao Ning, Wu Chang-Rui, Zhang Jian, Qin Li, Li Jing-Ming

机构信息

Department of Ophthalmology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.

Affiliated Eye Hospital of Nanchang University, Nanchang 330006, Jiangxi Provnice, China.

出版信息

Int J Ophthalmol. 2021 Mar 18;14(3):366-370. doi: 10.18240/ijo.2021.03.05. eCollection 2021.

Abstract

AIM

To analyze whether wet-lab training (WLT) or surgical-simulator training (SST) is better for ophthalmology residents to master the chopping technique.

METHODS

Sixty ophthalmology residents (in their second year) and three cataract surgeons participated in the study. The residents were randomly separated into two groups, WLT group and SST group. The residents in WLT group were asked to perform 10 trials of chopping using pig eyes and scored by the surgeons, and then they performed and scored using simulator for one time. The residents in SST group underwent 10 trials of chopping using simulator, and the simulator scored each trail. Then, this group were asked to perform the chopping using pig eyes and scored by the surgeons. At last, we investigated the residents' satisfaction about the training.

RESULTS

The demographic characteristics had no significant differences between the two groups. Recorded by the simulator, the residents in SST group got significantly higher overall score (83.90±1.31) than WLT group (78.73±1.92, =0.03). And the residents in SST group got less corner area injured, and they spend less time than WLT group (<0.05). Moreover, the residents in WLT group used more ultrasonic energy value than SST group (=0.03). However, scored by the surgeons, the residents in two groups got nearly the same overall score. The residents in WLT group performed better on the frequencies of posterior capsule torn and incisional stress (=0.03, 0.008, respectively). In the survey, the residents in two groups held the same opinion that the training was helpful and they strongly recommended this training. And all of them enjoyed the training, and enjoyed being randomized in their own group. However, with respect to the realistic character, the residents thought that WLT was better than SST (<0.001).

CONCLUSION

Both of the Eyesi surgical-stimulator and the wet-lab improve the residents' chopping ability and each has its own advantages. The combination of the two training ways could be considered to be a part of the training curriculum for new residents.

摘要

目的

分析实操训练(WLT)或手术模拟器训练(SST)对眼科住院医师掌握劈核技术是否更有帮助。

方法

60名(二年级)眼科住院医师和3名白内障外科医生参与了该研究。住院医师被随机分为两组,即WLT组和SST组。WLT组的住院医师被要求使用猪眼进行10次劈核操作并由外科医生评分,然后他们使用模拟器进行一次操作并评分。SST组的住院医师使用模拟器进行10次劈核操作,模拟器对每次操作进行评分。然后,该组被要求使用猪眼进行劈核操作并由外科医生评分。最后,我们调查了住院医师对培训的满意度。

结果

两组的人口统计学特征无显著差异。根据模拟器记录,SST组住院医师的总体得分(83.90±1.31)显著高于WLT组(78.73±1.92,P=0.03)。并且SST组住院医师的角膜损伤面积更小,且比WLT组花费的时间更少(P<0.05)。此外,WLT组住院医师使用的超声能量值比SST组更多(P=0.03)。然而,根据外科医生的评分,两组住院医师的总体得分几乎相同。WLT组住院医师在晶状体后囊膜撕裂频率和切口应力方面表现更好(分别为P=0.03,0.008)。在调查中,两组住院医师都认为培训很有帮助,并强烈推荐这种培训。他们都很享受培训,并且喜欢被随机分配到自己所在的组。然而,在真实感方面,住院医师认为WLT比SST更好(P<0.001)。

结论

Eyesi手术模拟器和实操训练都能提高住院医师的劈核能力,且各有优势。两种训练方式的结合可被视为新住院医师培训课程的一部分。

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