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新型腭裂手术模拟器的教育影响:提高手术培训师的知识和信心。

Educational impact of a novel cleft palate surgical simulator: Improvement in surgical trainees' knowledge and confidence.

机构信息

Evelina London Children's Hospital, London, United Kingdom.

Evelina London Children's Hospital, London, United Kingdom.

出版信息

J Plast Reconstr Aesthet Surg. 2022 Oct;75(10):3817-3825. doi: 10.1016/j.bjps.2022.06.079. Epub 2022 Jun 25.

Abstract

BACKGROUND

Trainees' experience in cleft surgery is limited due to the high-risk nature of the surgery and centralization of cleft care. Simulation training allows trainees to learn complex surgical tasks whilst ensuring patient safety. Existing cleft surgical simulators are over-simplified or prohibitively expensive. In this article, we show the development and application of a high-fidelity yet cost-effective simulator for cleft palate repair.

METHODS

Skeletal elements were obtained through high-resolution scanning of a pathologic specimen, 3-dimensional printed, and then molded in plastic. Soft tissue components were formed through molding layers of silicone. The simulator was tested by 26 United Kingdom (UK) specialty trainees who performed a vomerine mucosal flap and intra-velar veloplasty in a 1-hour workshop. Pre- and post-simulation questionnaires assessing cleft knowledge and surgical confidence were compared for statistical significance.

RESULTS

The simulator had high acceptability: 23/26 participants confirmed that the simulation training was a valuable learning experience. Baseline experience of cleft palate surgery was low: 24 participants had never performed any part of the procedure before. Following the workshop, mean knowledge score increased by 38%, and confidence by 53%. The paired T-test demonstrated that observed improvements in both knowledge and confidence were statistically significant (p<0.001).

CONCLUSIONS

Simulation training is increasingly recognized as a crucial component of improving patient safety. Our new cost-effective cleft palate simulator has high acceptability and is a powerful educational tool that is effective in improving cleft palate surgical knowledge and confidence across all grades of surgical trainees.

摘要

背景

由于手术风险高且腭裂治疗集中化,受训者在腭裂手术方面的经验有限。模拟训练可以让受训者在确保患者安全的情况下学习复杂的手术任务。现有的腭裂手术模拟器过于简单或过于昂贵。在本文中,我们展示了一种高保真但具有成本效益的腭裂修复模拟器的开发和应用。

方法

通过对病理解剖标本进行高分辨率扫描,获得骨骼元素,然后通过 3D 打印并在塑料中成型。软组织组件通过模制硅胶层形成。该模拟器由 26 名英国(UK)专业受训者进行了测试,他们在 1 小时的工作坊中进行了鼻甲粘膜瓣和内腭裂成形术。比较了术前和术后评估腭裂知识和手术信心的问卷,以确定统计意义。

结果

模拟器具有高度的可接受性:26 名参与者中有 23 名确认模拟培训是一次有价值的学习体验。腭裂手术的基线经验较低:24 名参与者以前从未进行过该手术的任何部分。在工作坊结束后,知识得分平均增加了 38%,信心得分增加了 53%。配对 T 检验表明,知识和信心的观察到的改善均具有统计学意义(p<0.001)。

结论

模拟培训越来越被认为是提高患者安全性的关键组成部分。我们新的具有成本效益的腭裂模拟器具有高度的可接受性,是一种强大的教育工具,可有效提高各级外科受训者的腭裂手术知识和信心。

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