University of Michigan Medical School, Ann Arbor, MI, USA.
MD Anderson Center, Thoracic Surgery, San Antonio, TX, USA.
J Robot Surg. 2022 Apr;16(2):409-413. doi: 10.1007/s11701-021-01258-9. Epub 2021 May 29.
Simulation is increasingly being used to train surgeons and access technical competency in robotic skills. The construct validity of using simulation performance for high-stakes examinations such as credentialing has not been studied appropriately. There are data on how simulation exercises can differentiate between novice and expert surgeons, but there are limited data to support their use for distinguishing intermediate from competent surgeons. Senior cardiothoracic trainees with limited robotic but significant laparoscopic experience ("intermediate surgeons", IS) and practicing robotic thoracic surgeons ("competent surgeons", CS) participating in a thoracic cadaver robotic course were evaluated on three Da Vinci (Xi) simulations. Scores were separately recorded into components and analyzed by t-test for significant differences between groups. 21 competent and 17 intermediate surgeons participated. Overall scores did not have a statistically significant difference in any exercise between groups. Simulation exercises do not appear to distinguish intermediate from competent surgeon performance of robotic skills. Without better validity data, the use of simulation for credentialing should be thoughtfully considered.
模拟训练越来越多地被用于培训外科医生和评估机器人技能的熟练程度。但是，使用模拟训练来评估资格认证等高风险考试的构建有效性尚未得到适当研究。虽然有数据表明模拟练习可以区分新手和专家外科医生，但支持使用它们来区分中级和熟练外科医生的数据有限。参与胸腔尸体机器人课程的具有有限机器人但具有显著腹腔镜经验的高级心胸外科受训者（“中级外科医生”，IS）和实践机器人胸腔外科医生（“熟练外科医生”，CS）在三个达芬奇（Xi）模拟器上进行了评估。将分数分别记录到各个组成部分中，并通过 t 检验对组间的显著差异进行分析。共有 21 名熟练外科医生和 17 名中级外科医生参加了测试。在任何练习中，两组之间的整体得分均无统计学差异。模拟练习似乎无法区分中级和熟练外科医生的机器人技能表现。在没有更好的有效性数据的情况下，应慎重考虑使用模拟训练来进行资格认证。
