Whittaker George, Ghita Ioana-Alexandra, Taylor Marcus, Salmasi M Yousuf, Granato Felice, Athanasiou Thanos
Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Department of Cardiothoracic Surgery, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Craiova, Romania.
Ann Thorac Surg. 2023 Nov;116(5):1107-1115. doi: 10.1016/j.athoracsur.2023.05.002. Epub 2023 May 16.
Simulation is playing an increasingly important role in surgical training but is not yet a mandatory part of most surgical curricula. A simulator must undergo rigorous validation to verify it as a reliable tool. The aim of this study was to review the literature to identify simulators that are currently available to augment thoracic surgical training and to analyze any evidence supporting or validating them.
A literature search of the MEDLINE (1946 to November 2022) and Embase (1947 to November 2022) databases was performed to identify simulators for basic skills and procedures in thoracic surgery. A selection of keywords were used to perform the literature search. After identification of appropriate articles, data were extracted and analyzed.
Thirty-three simulators were found in 31 articles. Simulators for basic skills (n = 13) and thoracic lobectomy (n = 13) were most commonly described, followed by miscellaneous (n = 7). Most models were of a hybrid modality (n = 18). Evidence of validity was established in 48.5% (n = 16) of simulators. In total, 15.2% (n = 5) of simulators had 3 or more elements of validity demonstrated, and only 3.0% (n = 1) accomplished full validation.
Numerous simulators of varying modality and fidelity exist for a variety of thoracic surgical skills and procedures, although validation evidence is frequently inadequate. Simulation models may be able to provide training in basic surgical and procedural skills; however, further assessment of validity needs to be undertaken before consideration of their integration into training programs.
模拟在外科培训中发挥着越来越重要的作用，但尚未成为大多数外科课程的必修部分。模拟器必须经过严格验证，以证明其作为可靠工具的有效性。本研究的目的是回顾文献，以确定目前可用于加强胸外科培训的模拟器，并分析支持或验证这些模拟器的任何证据。
对MEDLINE（1946年至2022年11月）和Embase（1947年至2022年11月）数据库进行文献检索，以确定胸外科基本技能和手术的模拟器。使用了一系列关键词进行文献检索。在确定合适的文章后，提取并分析数据。
在31篇文章中发现了33种模拟器。最常描述的是基本技能模拟器（n = 13）和肺叶切除术模拟器（n = 13），其次是其他类型（n = 7）。大多数模型为混合模式（n = 18）。48.5%（n = 16）的模拟器有有效性证据。总共15.2%（n = 5）的模拟器有3个或更多有效性要素得到证明，只有3.0%（n = 1）完成了全面验证。
存在多种模式和逼真度的众多模拟器，可用于各种胸外科手术技能和操作，尽管验证证据往往不足。模拟模型可能能够提供基本手术和操作技能的培训；然而，在考虑将其纳入培训计划之前，需要对其有效性进行进一步评估。
