学习腹腔镜手术手动技能基础：机构远程指导与评估经验
Learning Fundamentals of Laparoscopic Surgery Manual Skills: An Institutional Experience With Remote Coaching and Assessment.
作者信息
Miles Shana, Donnellan Nicole
机构信息
Department of Gynecologic Surgery and Obstetrics, Uniformed Services University, Bethesda, MD 20814, USA.
Department of Obstetrics, Gynecology, and Reproductive Sciences, UPMC Magee-Womens Hospital, Pittsburgh, PA 15213, USA.
出版信息
Mil Med. 2022 Oct 29;187(11-12):e1281-e1285. doi: 10.1093/milmed/usab170.
INTRODUCTION
COVID-19 has altered the landscape of traditional surgical education. This is a pilot study of remote coaching and assessment of Fundamentals of Laparoscopic Surgery (FLS) manual skills in obstetrics and gynecology residents.
MATERIALS AND METHODS
PGY-3 obstetrics and gynecology residents participated in remote assessment of FLS manual skills using a live streaming platform. Learners who showed deficiencies in proficiency participated in live-streamed coaching sessions. The coaching sessions continued until the learner and coach mutually agreed that the learner was prepared for the skills portion of the FLS certification exam. The primary outcome was learner performance on skills assessment with external validation through the FLS manual skills exam pass rate.
RESULTS
One learner demonstrated proficiency at baseline and the remaining nine underwent remote coaching sessions. Learners received a mean of two coaching sessions to reach mutually agreed readiness for the FLS exam as per learner and coach. All residents performed significantly better at the conclusion of the remote coaching series (11.3 ± 0.82) as compared to their baseline scores (8.8 ± 2.82) (P < .03; 95% CI, 0.31-4.69). Proficiency was externally validated through the FLS exam taken by each resident 1-2 weeks following their final assessment, with all learners passing the manual portion. The average satisfaction of learners with remote coaching was 77/100 (range 50-100). 100% of learners felt prepared for their FLS certification exam and 100% would recommend this remote training program to a colleague.
CONCLUSION
Remote coaching and assessment of FLS skills yields similar results to traditional face-to-face instruction.
引言
新型冠状病毒肺炎（COVID-19）改变了传统外科教育的格局。这是一项关于远程指导和评估妇产科住院医师腹腔镜手术基础（FLS）操作技能的试点研究。
材料与方法
PGY-3妇产科住院医师使用直播平台参与FLS操作技能的远程评估。在熟练度方面表现不足的学习者参加直播指导课程。指导课程持续进行，直到学习者和指导教师双方都认为该学习者已为FLS认证考试的技能部分做好准备。主要结果是通过FLS操作技能考试通过率进行外部验证的学习者在技能评估中的表现。
结果
一名学习者在基线时表现出熟练水平，其余九名接受了远程指导课程。根据学习者和指导教师的评估，学习者平均接受了两次指导课程，以达到双方都认可的准备好参加FLS考试的程度。与基线分数（8.8±2.82）相比，所有住院医师在远程指导系列结束时的表现（11.3±0.82）均有显著提高（P<.03；95%CI，0.31 - 4.69）。在每位住院医师最后评估后的1 - 2周，通过他们参加的FLS考试对熟练度进行了外部验证，所有学习者均通过了操作部分。学习者对远程指导的平均满意度为77/100（范围为50 - 100）。100%的学习者认为自己已为FLS认证考试做好准备，100%的学习者会向同事推荐这个远程培训项目。
结论
FLS技能的远程指导和评估产生的结果与传统面对面教学相似。
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