Department of Pediatric Surgery, Radboudumc - Amalia Children's Hospital, Nijmegen, The Netherlands.
Department of Surgery, Zuyderland, Heerlen, The Netherlands.
Surg Endosc. 2023 Jan;37(1):180-188. doi: 10.1007/s00464-022-09424-2. Epub 2022 Jul 28.
Simulation-based training may be used to acquire MIS skills. While mostly done in a simulation center, it is proposed that this training can be undertaken at-home as well. The aim of this study is to evaluate whether unsupervised at-home training and assessment of MIS skills is feasible and results in increased MIS skills.
Medical doctors and senior medical students were tested on their innate abilities by performing a pre-test on a take-home simulator. Henceforth, they followed a two-week interval training practicing two advanced MIS skills (an interrupted suture with knot tying task and a precise peg transfer task) and subsequently performed a post-test. Both tests and all training moments were performed at home. Performance was measured using motion analysis software (SurgTrac) and by expert-assessment and self-assessment using a competency assessment tool for MIS suturing (LS-CAT).
A total of 38 participants enrolled in the study. Participants improved significantly between the pre-test and the post-test for both tasks. They were faster (632 s vs. 213 s, p < 0.001) and more efficient (distance of instrument tips: 9.8 m vs. 3.4 m, p = 0.001) in the suturing task. Total LS-CAT scores, rated by an expert, improved significantly with a decrease from 36 at the pre-test to 20 at the post-test (p < 0.001) and showed a strong correlation with self-assessment scores (R 0.771, p < 0.001). The precise peg transfer task was completed faster (300 s vs. 163 s, p < 0.001) and more efficient as well (14.8 m vs. 5.7 m, p = 0.005). Additionally, they placed more rings correctly (7 vs. 12, p = 0.010).
Unsupervised at-home training and assessment of MIS skills is feasible and resulted in an evident increase in skills. Especially in times of less exposure in the clinical setting and less education on training locations this can aid in improving MIS skills.
基于模拟的培训可用于获取微创技能。虽然主要在模拟中心进行，但也有人提议在家中也可以进行这种培训。本研究的目的是评估非监督家庭培训和微创技能评估是否可行，并导致微创技能的提高。
医生和高年级医学生通过在家中使用便携式模拟器进行前测，来测试他们的先天能力。此后，他们进行了为期两周的间隔训练，练习两项高级微创技能（带打结的间断缝合和精确销钉转移任务），然后进行后测。所有测试和培训都在家中进行。使用运动分析软件（SurgTrac）以及使用微创缝合能力评估工具（LS-CAT）进行的专家评估和自我评估来测量表现。
共有 38 名参与者参加了这项研究。在两个任务中，参与者在前后测试之间都有显著提高。他们的速度更快（缝合任务中，632 秒对 213 秒，p<0.001），效率更高（器械尖端距离：9.8 米对 3.4 米，p=0.001）。专家评分的总 LS-CAT 评分显著提高，从前测的 36 分降至后测的 20 分（p<0.001），并与自我评估评分具有很强的相关性（R=0.771，p<0.001）。精确销钉转移任务完成得更快（300 秒对 163 秒，p<0.001），效率更高（14.8 米对 5.7 米，p=0.005）。此外，他们放置的环数更多（7 对 12，p=0.010）。
非监督家庭微创技能培训和评估是可行的，并且显著提高了技能。特别是在临床环境暴露较少和培训地点教育较少的情况下，这有助于提高微创技能。
