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多机构机器人手术课程开发中的需求评估:住院医师和外科教员的看法。

A Multi-Institutional Needs Assessment in the Development of a Robotic Surgery Curriculum: Perceptions From Resident and Faculty Surgeons.

机构信息

Department of Surgery, Cedars-Sinai Health Care System, Los Angeles, California.

Department of Surgery, Cedars-Sinai Health Care System, Los Angeles, California.

出版信息

J Surg Educ. 2023 Jan;80(1):93-101. doi: 10.1016/j.jsurg.2022.08.002. Epub 2022 Sep 6.

Abstract

BACKGROUND

The growing adoption of robotic-assisted surgery mandates residents must acquire robotic skills. No standardized curriculum for robotic surgery exists. Therefore, programs have developed their own curricula, which are often unstructured and based on resource availability. With this strategy programs may not adhere to scholarly approaches in curriculum development. We aimed to obtain a multi-institutional needs assessment to address training needs and identify integral components of a formalized robotic surgery curriculum.

METHODS

A 10-question survey was distributed to general surgery residents. A separate 7-question survey was sent to robotic faculty surgeons at 3 institutions. Survey questions queried demographics, opinions regarding robotic training, proficiency definitions, and identification of procedures and instructional strategies for a curriculum. Mann- Whitney U test and Fisher's exact test were performed to compare responses amongst residents and faculty. Spearman's correlation was used to identify relationships between experience or post-graduate year (PGY) with response selection.

RESULTS

Both residents and faculty believed robotic training should start in the PGY1 (55.1% vs 52%; p = 0.58). Faculty recognized robotic training to be more important compared to residents (84% vs 58.1%; p < 0.05). Both groups considered a minimum of 21 to 40 robotic cases to be sufficient exposure during training (p = 0.30). Cholecystectomy (82.4% vs 72%; p = 0.261), ventral hernia repair (89.2% vs 88%; p = 1.0), inguinal hernia repair (91.9% vs 92%; p = 1.0), and right colectomy (83.8% vs 80%; p = 0.7) were considered to be the most appropriate robotic procedures during training. Both groups concurred that bedside (91.9% vs 100%; p = 0.33) and console skills training (97.3% vs 100%; p = 1.0), small group simulation (94.6% vs 72% p = 0.005), and independent practice (87.8% vs 92% p = 0.73), were instructional strategies vital to a curriculum. Faculty considered online didactic modules (96% vs 59.5%; p < 0.05) to be more important, whereas residents favored small group experiences for fundamental skills (94.6% vs. 72%; p < 0.05) and procedure-based simulation (96% vs 64%; p < 0.05).

CONCLUSIONS

Our targeted needs assessment identified requisite components of a robotics curriculum, which are feasible and accepted by both residents and faculty. Medical educators can use this as a resource to develop a formal robotics training curriculum.

摘要

背景

机器人辅助手术的广泛采用要求住院医师必须掌握机器人技能。目前还没有标准化的机器人手术课程。因此,各项目都制定了自己的课程,但这些课程往往没有结构,并且取决于资源的可用性。采用这种策略,项目可能无法坚持课程开发中的学术方法。我们旨在进行多机构需求评估,以解决培训需求并确定规范化机器人手术课程的基本组成部分。

方法

向普通外科住院医师分发了 10 个问题的调查问卷。在 3 个机构向机器人外科医生发送了单独的 7 个问题的调查问卷。调查问卷询问了人口统计学,对机器人培训的看法,熟练程度的定义,以及课程的程序和教学策略。曼-惠特尼 U 检验和 Fisher 确切检验用于比较住院医师和教职员工的反应。使用 Spearman 相关系数来确定经验或研究生年(PGY)与响应选择之间的关系。

结果

住院医师和教职员工都认为机器人培训应在 PGY1 开始(分别为 55.1%和 52%;p = 0.58)。与住院医师相比,教职员工认为机器人培训更为重要(分别为 84%和 58.1%;p <0.05)。两组均认为在培训期间至少要进行 21 到 40 例机器人手术才能获得足够的暴露(p = 0.30)。胆囊切除术(82.4%与 72%;p = 0.261),腹疝修补术(89.2%与 88%;p = 1.0),腹股沟疝修补术(91.9%与 92%;p = 1.0)和右结肠切除术(83.8%与 80%;p = 0.7)被认为是培训期间最适合的机器人手术。两组均认为床边(91.9%与 100%;p = 0.33)和控制台技能培训(97.3%与 100%;p = 1.0),小组模拟(94.6%与 72%;p = 0.005)和独立实践(87.8%与 92%;p = 0.73)是课程的重要教学策略。教职员工认为在线教学模块(96%与 59.5%;p <0.05)更为重要,而住院医师则更喜欢小组体验来进行基本技能(94.6%与 72%;p <0.05)和基于程序的模拟(96%与 64%;p <0.05)。

结论

我们的针对性需求评估确定了机器人课程的必要组成部分,这些组成部分对住院医师和教职员工都是可行且可接受的。医学教育者可以将其用作开发正式机器人培训课程的资源。

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