Ackermann Johannes, Pahls Julia, Baumann Jorun, Spüntrup Carolin, Holthaus Bernd, Noé Günter, Anapolski Michael, Meinhold-Heerlein Ivo, Laganà Antonio Simone, Peters Göntje, Pape Julian, Willer Damaris, Westermann Anna Maria, Günther Veronika, Maass Nicolai, Mettler Liselotte, Alkatout Ibrahim
Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany.
Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital of Giessen, Klinikstr. 33, 35392, Gießen, Germany.
Int J Surg. 2022 May;101:106604. doi: 10.1016/j.ijsu.2022.106604. Epub 2022 Apr 7.
Minimally invasive surgical procedures have a flat learning curve, especially in the initial period of a surgeon's training. Pelvitrainers enable the prospective surgeon to drill the surgical technique, including camera navigation, instrument manipulation, and the individual steps of the operation, on a model rather than a patient. Integrating the pelvitrainer into standardized surgical training programs is challenging, but would be essential to achieve optimum effects of long duration in surgical education.
The pelvitrainer Realsimulator 2.0 (Endodevelop) was evaluated in 16 standardized training courses (at three training centers) of the German Working Group for Gynecological Endoscopy (AGE e.V.) from 2017 to 2020, The training concept was implemented and evaluated in a prospective, multicenter, interdisciplinary, multinational setting.
One hundred and eighty of 206 physicians (response rate 87.4%) completed the multi-stage training concept successfully. A significant (p < 0.001) objective improvement (positive learning curve) was observed for all exercises on the pelvitrainer. The trainer's subjective evaluation revealed positive ratings for design (median 82%, IQR 71-91%), camera navigation (87%, IQR 76-95%), and instrument manipulation (median 87%, IQR 77-94%). A follow-up survey performed six months after the course confirmed its sustainable and high benefits in clinical routine (median 82%, IQR 70-97%).
The present investigation proved the high educational value of pelvitrainers, which can be enhanced by using a structured training concept. The benefit of training courses for health care justifies their incorporation into a standardized training curriculum. The completion of such training courses should be regarded as a prerequisite for a doctor to qualify as an independent surgeon.
微创手术操作的学习曲线平缓，尤其是在外科医生培训的初期。骨盆训练器能让未来的外科医生在模型而非患者身上演练手术技巧，包括摄像头导航、器械操作以及手术的各个步骤。将骨盆训练器纳入标准化手术培训项目具有挑战性，但对于在外科教育中实现长期的最佳效果至关重要。
2017年至2020年期间，在德国妇科内镜工作组（AGE e.V.）的16个标准化培训课程（于三个培训中心开展）中对骨盆训练器Realsimulator 2.0（Endodevelop）进行了评估。该培训理念在一项前瞻性、多中心、跨学科、跨国的环境中得以实施和评估。
206名医生中有180名（应答率87.4%）成功完成了多阶段培训理念。在骨盆训练器上进行的所有练习均观察到显著的（p < 0.001）客观改善（正向学习曲线）。培训师的主观评价显示，对设计（中位数82%，四分位间距71 - 91%）、摄像头导航（87%，四分位间距76 - 95%）和器械操作（中位数87%，四分位间距77 - 94%）给予了积极评价。课程结束六个月后进行的随访调查证实了其在临床常规中的可持续性和高收益（中位数82%，四分位间距70 - 97%）。
本研究证明了骨盆训练器具有很高的教育价值，通过使用结构化培训理念可进一步提高其价值。医疗保健培训课程的益处证明了将其纳入标准化培训课程的合理性。完成此类培训课程应被视为医生具备独立手术资格的先决条件。
