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微创外科住院医师培训。

Residency training for minimally invasive surgery.

机构信息

- Hospital das Clínicas da Universidade Federal de Minas Gerais, Centro de Treinamento e Educação Cirúrgica - Belo Horizonte - MG - Brasil.

出版信息

Rev Col Bras Cir. 2022 Feb 28;49:e20213040. doi: 10.1590/0100-6991e-20213040. eCollection 2022.

Abstract

OBJECTIVE

to develop a training program in minimally invasive surgery, based on simulation and with an emphasis on the acquisition of laparoscopic competences.

METHODS

this was a prospective, observational study carried out at a university hospital in Belo Horizonte, Brazil, between April 2020 and January 2021. We recruited residents of surgical specialties for structured, progressive training according to instructional principles to promote learning, such as motivation, activation, demonstration, application, and integration. We filmed the skill tests at the program's beginning, middle, and end, which were then anonymously evaluated by a surgical education expert. Individual performances were scored using the global assessment tools "GOALS" and "specific checklist for suture". At the end, all participants received individual feedback and completed a questionnaire to assess the impact of training on the Kirkpatrick model.

RESULTS

43 residents completed the program. The evolution of performances was evident and grew between tests. The average achievements were 29% in the initial test, 43% in the intermediate test, and 88% in the final test, with significant differences between all mean scores, with H=97.59, GL=2, p<0.0001. The program evaluation and learning perceptions were excellent, but only 10.7% of residents felt fully capable of performing unsupervised, low-complexity laparoscopic surgery at the end of training.

CONCLUSIONS

the training program developed in this study proved to be feasible and promising as a strategy for teaching laparoscopic surgery.

摘要

目的

开发一项基于模拟且注重腹腔镜技能获取的微创手术培训计划。

方法

这是一项在巴西贝洛奥里藏特的一所大学医院进行的前瞻性、观察性研究。我们招募了外科专业的住院医师,根据促进学习的教学原则(如激励、激活、演示、应用和整合)进行结构化、渐进式培训。我们在培训开始、中期和结束时对技能测试进行录像,然后由一位外科教育专家对其进行匿名评估。使用全球评估工具“GOALS”和“特定缝合检查表”对个人表现进行评分。最后,所有参与者都收到了个人反馈,并完成了一份评估培训对柯克帕特里克模型影响的问卷。

结果

共有 43 名住院医师完成了该计划。表现的演变是明显的,并且在测试之间不断增长。初始测试的平均得分为 29%,中间测试的平均得分为 43%,最终测试的平均得分为 88%,所有平均分数之间均存在显著差异,H=97.59,GL=2,p<0.0001。该计划的评估和学习感知非常出色,但只有 10.7%的住院医师在培训结束时感到完全有能力独立进行低复杂度的腹腔镜手术。

结论

本研究中开发的培训计划被证明是可行且有前途的腹腔镜手术教学策略。

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