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手术模拟补充了生殖内分泌与不孕症专科培训。

Surgical simulation supplements reproductive endocrinology and infertility fellowship training.

作者信息

Chase Tess, Shah Divya K, Parry J Preston, Bhagavath Bala, Lindheim Steven R, Petrozza John C, Pfeifer Samantha, Stetter Christina, Kunselman Allen, Estes Stephanie J

机构信息

Department of Obstetrics and Gynecology, Penn State Hershey Medical Center, Hershey, Pennsylvania.

Division of Reproductive Endocrinology, University of Pennsylvania, Philadelphia, Pennsylvania.

出版信息

F S Rep. 2020 Sep 28;1(2):154-161. doi: 10.1016/j.xfre.2020.06.002. eCollection 2020 Sep.

Abstract

OBJECTIVE

To assess if a surgical boot camp improves laparoscopic skill among reproduction endocrinology and infertility (REI) fellows and increases fellow desire to incorporate surgical skills into practice and to examine whether fellowship in vitro fertilization (IVF) volume correlates with surgical efficiency.

DESIGN

Prospective evaluation.

SETTING

Simulation Center.

PATIENTS

Forty REI fellows.

INTERVENTIONS

Fellows were timed before and after training in laparoscopic suturing and knot tying and while using virtual simulators. Fellows were surveyed before boot camp on prior experience with IVF and reproductive surgery, and immediately and 1 month after boot camp on their desire to incorporate surgical skills into practice.

MAIN OUTCOME MEASURES

Efficiency of laparoscopic suturing and knot tying before and after boot camp; likelihood and persistence of incorporating surgical skills into practice immediately and 1 month after boot camp; and correlation between fellowship IVF volume and fellow surgical efficiency.

RESULTS

Fellows experienced significant improvement in laparoscopic suturing (44 sec), intracorporeal knot tying (82 sec), and extracorporeal knot tying (71 sec). Fellows reported being more likely to incorporate operative hysteroscopy (89%), operative laparoscopy (87%), and laparoscopic suturing (84%) into practice immediately following boot camp with no difference 1 month later. Fifty-four percent of fellows reported being more likely to perform robotic surgery after the boot camp, increasing to 70% 1 month later. There were weak correlations between IVF case volume and efficiency in laparoscopic suturing or hysteroscopic polypectomy (Spearman correlation coefficients, -0.14 and -0.03).

CONCLUSIONS

An intensive surgical boot camp enhances surgical skill among REI fellows.

摘要

目的

评估外科实战训练营是否能提高生殖内分泌与不孕症(REI)专科住院医师的腹腔镜手术技能,增强他们将手术技能应用于临床实践的意愿,并研究体外受精(IVF)专科培训量与手术效率之间的相关性。

设计

前瞻性评估。

地点

模拟中心。

患者

40名REI专科住院医师。

干预措施

对住院医师在腹腔镜缝合和打结训练前后以及使用虚拟模拟器时进行计时。在训练营开始前,对住院医师进行关于IVF和生殖手术既往经验的调查,并在训练营结束后立即以及结束后1个月,调查他们将手术技能应用于临床实践的意愿。

主要观察指标

训练营前后腹腔镜缝合和打结的效率;训练营结束后立即以及结束后1个月将手术技能应用于临床实践的可能性和持续性;以及专科培训IVF量与住院医师手术效率之间的相关性。

结果

住院医师在腹腔镜缝合(缩短44秒)、体内打结(缩短82秒)和体外打结(缩短71秒)方面有显著改善。住院医师报告称,训练营结束后立即更有可能将宫腔镜手术(89%)、腹腔镜手术(87%)和腹腔镜缝合(84%)应用于临床实践,1个月后无差异。54%的住院医师报告称训练营后更有可能进行机器人手术,1个月后这一比例增至70%。IVF病例量与腹腔镜缝合或宫腔镜下息肉切除术效率之间的相关性较弱(斯皮尔曼相关系数分别为-0.14和-0.03)。

结论

强化外科实战训练营可提高REI专科住院医师的手术技能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eab5/8244323/23ce81c759c5/gr1.jpg

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