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使用模拟器教授心脏瓣膜手术技术:系统评价。

Teaching heart valve surgery techniques using simulators: a systematic review.

机构信息

From the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (EL-Andari, Kang, Fialka); the Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, Alta. (Bozso, Nagendran); and the Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alta. (Adams).

From the Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta. (EL-Andari, Kang, Fialka); the Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, Alta. (Bozso, Nagendran); and the Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alta. (Adams)

出版信息

Can J Surg. 2023 Mar 17;66(2):E139-E149. doi: 10.1503/cjs.017921. Print 2023 Mar-Apr.

Abstract

The apprentice model has traditionally been the primary method of teaching cardiac surgery trainees. Limitations of this model include insufficient time to learn all necessary skills, minimal exposure to rare cases and to complex repair techniques, small number of patients in small centres, high cost and absence of objective measures of feedback. In recent years, simulation-based training (SBT) has been used in order to address the gaps left by the apprentice model. We performed a systematic review of PubMed and Embase for articles investigating the use of SBT in teaching surgical valve techniques published in 2022 or earlier in order to summarize the current literature regarding the use of SBT for trainees learning surgical valve repair and replacement techniques. We compiled data on the impact of SBT on time to completion of tasks, proportion of trainees who committed technical errors, skills scores and theoretical knowledge. Studies in which outcomes were evaluated showed significant improvement in these measures after participation in SBT. Simulation-based training has been shown to improve the surgical skills of trainees in a rela-tively short period. As hands-on experience in the field of cardiac surgery is invaluable and often difficult to reproduce effectively, it is likely that a combination of hands-on training and SBT will be adopted moving forward to provide optimal exposure for surgical trainees.

摘要

学徒模式一直是心脏外科培训生的主要教学方法。该模式的局限性包括:学习所有必要技能的时间不足,很少接触罕见病例和复杂修复技术,小中心的患者数量少,成本高,缺乏客观的反馈措施。近年来,基于模拟的培训(SBT)已被用于弥补学徒模式留下的空白。我们对 PubMed 和 Embase 进行了系统检索,以查找 2022 年或更早发表的关于 SBT 在教授外科瓣膜技术中的应用的文章,以总结关于 SBT 在培训外科瓣膜修复和置换技术方面的应用的当前文献。我们收集了关于 SBT 对完成任务时间、技术错误发生率、技能得分和理论知识的影响的数据。已评估结果的研究表明,参与者在接受 SBT 后,这些指标均有显著改善。在相对较短的时间内,基于模拟的培训已显示出可提高学员的手术技能。由于心脏外科领域的实践经验是非常宝贵的,而且往往难以有效复制,因此,在未来,动手培训和 SBT 的结合可能会被采用,为外科培训生提供最佳的实践经验。

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