Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Surgery, Mayo Clinic, Rochester, MN, USA.
J Chin Med Assoc. 2022 Feb 1;85(2):259-262. doi: 10.1097/JCMA.0000000000000654.
Total implantable venous access port (TIVAP) by cephalic vein cutdown (CVCD) is one of the first procedures surgery residents can be performed independently under supervision. There is currently a lack of affordable simulators for teaching and assessing TIVAP competency to improve patient safety. A panel of 10 experts divided the TIVAP by CVCD procedure into 9 steps. A homemade, low-cost ($3 USD) simulator was then designed for practicing standardized procedural steps in the context of a simulation-based mastery learning course. Residents were given a simulator for at-home practice and completed a survey evaluating the simulator and their learning experience. Twenty-eight first-year surgery residents participated in the course and completed the survey. They were highly satisfied with the simulator (mean score = 8.7 of 10) and generally agreed with its anatomical appearance and functional fidelity. They also appreciated the educational value of using this simulator to learn and practice basic techniques and procedural steps. Our novel, homemade simulator of CVCD TIVAP implantation is a cost-effective way of achieving procedural competence of a basic operation for inexperienced surgery residents. We envision the same principle can be applied to other procedures to enhance resident education.
经头静脉切开（CVCD）植入全植入式静脉通路端口（TIVAP）是手术住院医师在监督下可以独立进行的首批操作之一。目前，缺乏经济实惠的模拟设备来教授和评估 TIVAP 能力，以提高患者安全性。一个由 10 名专家组成的小组将 CVCD 下的 TIVAP 操作分为 9 个步骤。然后，设计了一种自制的、低成本（3 美元）的模拟器，以便在基于模拟的精通学习课程中练习标准化的操作步骤。住院医师获得了一个模拟器在家中练习，并完成了一份评估模拟器和他们学习体验的调查问卷。28 名一年级外科住院医师参加了该课程并完成了调查。他们对模拟器非常满意（平均得分为 10 分中的 8.7 分），并普遍同意其解剖外观和功能逼真度。他们还赞赏使用此模拟器学习和练习基本技术和操作步骤的教育价值。我们的 CVCD TIVAP 植入术的新型自制模拟器是一种具有成本效益的方法，可以使经验不足的外科住院医师获得基本操作的程序能力。我们设想同样的原则可以应用于其他程序，以增强住院医师的教育。
