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泌尿外科住院医师微创手术训练中的低保真模拟模型。

Low-fidelity simulation models in urology resident's microsurgery training.

机构信息

Universidade Estadual do Pará - Department of Integrated Health - Belém (PA), Brazil.

Universidade Estadual do Pará - Department of Morphophysiology Applied to Health - Belém (PA), Brazil.

出版信息

Acta Cir Bras. 2023 Dec 1;38:e386523. doi: 10.1590/acb386523. eCollection 2023.

Abstract

PURPOSE

To evaluate the gain of microsurgical skills and competencies by urology residents, using low-fidelity experimental models.

METHODS

The study involved the use of training boards, together with a low-fidelity microsurgery simulator, developed using a 3D printer. The model consists in two silicone tubes, coated with a resin, measuring 10 cm in length and with internal and external diameters of 0.5 and 1.5 mm. The support for the ducts is composed by a small box, developed with polylactic acid. The evaluation of the gain of skills and competencies in microsurgery occurred throughout a training course consisting of five training sessions. The first sessions (S1-S4) took place at weekly intervals and the last session (S5) was performed three months after S4. During sessions, were analyzed: the speed of performing microsurgical sutures in the pre and post-training and the performance of each resident through the Objective Structure Assessment of Technical Skill (OSATS) and Student Satisfaction Self-Confidence tools in Learning (SSSCL).

RESULTS

There was a decrease in the time needed to perform the anastomosis (p=0.0019), as well as a progressive increase in the score in the OSATS over during sessions S1 to S4. At S5, there was a slightly decrease in performance (p<0.0001), however, remaining within the expected plateau for the gain of skills and competences. The SSSCL satisfaction scale showed an overall approval rating of 96.9%, with a Cronback alpha coefficient of 83%.

CONCLUSIONS

The low-fidelity simulation was able to guarantee urology residents a solid gain in skills and competencies in microsurgery.

摘要

目的

通过使用低保真度实验模型,评估泌尿科住院医师在显微手术技能方面的收获。

方法

本研究使用了培训板,并结合了使用 3D 打印机开发的低保真度显微手术模拟器。该模型由两个涂有树脂的硅胶管组成,长 10 厘米,内径和外径分别为 0.5 和 1.5 毫米。管道的支撑由聚乳酸制成的小盒子组成。通过五个培训课程来评估显微手术技能和能力的提高,每个课程之间相隔一周。最后一次课程(S5)是在 S4 之后三个月进行的。在每次课程中,都分析了以下内容:在培训前后进行显微缝合的速度,以及每位住院医师通过客观结构评估技术技能(OSATS)和学习学生满意度自我信心工具(SSSCL)的表现。

结果

进行吻合术所需的时间减少(p=0.0019),并且在 S1 到 S4 的课程中,OSATS 的得分逐渐增加。在 S5 时,表现略有下降(p<0.0001),但仍在技能和能力提高的预期平台内。SSSCL 满意度量表的总体满意度评分为 96.9%,Cronbach alpha 系数为 83%。

结论

低保真度模拟能够确保泌尿科住院医师在显微手术技能方面获得扎实的收获。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f30d/10691177/5fce4bfc5521/1678-2674-acb-38-e386523-gf01.jpg

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