Department of Pediatric Surgery, Radboud University Medical Center - Amalia Children's Hospital, Geert Grooteplein Zuid 10 route 618, Nijmegen, 6500HB, The Netherlands.
Department of Pediatric Surgery, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Surg Endosc. 2022 Nov;36(11):8307-8315. doi: 10.1007/s00464-022-09277-9. Epub 2022 May 23.
Skill deterioration of minimally invasive surgical (MIS) skills may be prevented by continuous training. The aim of this study is to evaluate whether unsupervised continuous at-home training of MIS skills results in better skill retention compared to no training.
Medical doctors followed a two-week interval training for two MIS tasks (precise peg transfer and interrupted suture with knot tying), ending with a baseline test. They were randomly assigned to the no-practice group or continuous-practice group. The latter practiced unsupervised at home every two weeks during the study period. Skill retention was measured after three and six months on both tasks by the total time needed, distance traveled by instruments and LS-CAT score (8 best possible score and > 40 worst score).
A total of 38 participants were included. No significant differences in performance were found at pre-test or baseline. At six months the no-practice group needed more time for the suturing task (309 s vs. 196 s at baseline, p = 0.010) and the LS-CAT score was significantly worse (30 vs. 20 at baseline, p < 0.0001). The continuous-practice group performed the suturing task significantly better than the no-practice group at both three and six months (17 vs. 25, p < 0.001 and 17 vs. 30, p < 0.001) and faster as well (p = 0.034 and p = 0.001).
This study shows a skill decay after only a few months of non-use and shows better skill retention after continuous unsupervised at-home practice of MIS skills. This indicates an added value of regular at-home practice of surgical skills.
微创外科（MIS）技能的熟练程度可能会因持续训练而得到提高。本研究旨在评估 MIS 技能的非监督持续家庭训练是否比不训练更能更好地保持技能。
医生们进行了为期两周的间隔训练，共进行了两项 MIS 任务（精确的销钉转移和间断缝合打结），最后进行了基线测试。他们被随机分配到无练习组或连续练习组。后者在研究期间每两周在家进行一次非监督练习。在三个月和六个月时，通过总用时、器械行驶距离和 LS-CAT 评分（8 分为最佳，>40 分为最差）测量两项任务的技能保持情况。
共有 38 名参与者被纳入研究。在预测试或基线时，两组的表现没有显著差异。在六个月时，无练习组在缝合任务中需要更多的时间（309 秒 vs. 196 秒，p=0.010），LS-CAT 评分也明显更差（30 分 vs. 基线时的 20 分，p<0.0001）。在三个月和六个月时，连续练习组在缝合任务中的表现均明显优于无练习组（17 分 vs. 25 分，p<0.001 和 17 分 vs. 30 分，p<0.001），用时也更短（p=0.034 和 p=0.001）。
本研究表明，仅几个月不使用就会导致技能衰退，并显示出在 MIS 技能的持续非监督家庭练习后，技能保持更好。这表明定期进行手术技能的家庭练习具有附加价值。
