Center for Thoracic Surgery, Department of Medicine and Surgery (DMC), University of Insubria, Varese, Italy.
General, Emergency and Transplant Surgery, Department of Medicine and Innovation Technology (DiMIT), University of Insubria, Varese, Italy.
Eur J Cardiothorac Surg. 2024 Feb 1;65(2). doi: 10.1093/ejcts/ezae044.
Virtual training simulators have been introduced in several surgical disciplines to improve residents' abilities. Through the use of the LapSim® virtual training simulator (Surgical Science, Göteborg, Sweden), this study aims to plan an effective learning path in minimally invasive thoracic and general surgery.
All thoracic and general surgery trainees in their 1st and 2nd year of residency at the University of Insubria were enrolled and randomized into 2 groups: residents undergoing an intensive twice-a-week virtual training programme (group A: n = 8) and those undergoing a once-weekly non-intensive virtual training programme (group B: n = 9). The virtual training programme was divided into 4 modules, each of 12 weeks. In the 1st module, trainees repeated grasping, cutting, clip application, lifting and grasping, and fine dissection exercises during each training session. Seal-and-cut exercise was performed as the initial and final test. Data on surgical manoeuvres (time and on mistakes) were collected; intra- and inter-group comparisons were planned.
No significant differences were observed between groups A and B at the 1st session, confirming that the 2 groups had similar skills at the beginning. After 12 weeks, both groups showed improvements, but comparing data between initial and final test, only Group A registered a significant reduction in total time (P-value = 0.0015), left (P-value = 0.0017) and right (P-value = 0.0186) instrument path lengths, and in left (P-value = 0.0010) and right (P-value = 0.0073) instrument angular path lengths, demonstrating that group A acquired greater precision in surgical manoeuvres.
Virtual simulator training programme performed at least twice a week was effective for implementing basic surgical skills required for the trainee's professional growth. Additional virtual training modules focused on more complex exercises are planned to confirm these preliminary results.
虚拟训练模拟器已在多个外科领域引入,以提高住院医师的能力。本研究旨在通过使用 LapSim®虚拟训练模拟器(瑞典哥德堡 Surgical Science),为微创胸外科和普通外科规划有效的学习路径。
所有在因苏布里亚大学进行第 1 年和第 2 年住院医师培训的胸外科和普通外科住院医师均被纳入并随机分为 2 组:接受每周 2 次强化虚拟培训方案的住院医师(A 组:n=8)和接受每周 1 次非强化虚拟培训方案的住院医师(B 组:n=9)。虚拟培训方案分为 4 个模块,每个模块持续 12 周。在第 1 个模块中,每位学员在每次培训课程中重复进行握持、切割、夹取、提拉和精细解剖练习。密封和切割练习作为初始和最终测试。收集手术操作(时间和失误)的数据;计划了组内和组间比较。
第 1 次课程时,A 组和 B 组之间无显著差异,证实 2 组在开始时具有相似的技能。经过 12 周后,2 组均有所改善,但将初始测试和最终测试的数据进行比较时,仅 A 组的总时间(P 值=0.0015)、左(P 值=0.0017)和右(P 值=0.0186)器械路径长度以及左(P 值=0.0010)和右(P 值=0.0073)器械角度路径长度显著减少,表明 A 组在手术操作中获得了更高的精度。
每周至少进行 2 次虚拟模拟器培训方案对于实施住院医师专业成长所需的基本手术技能是有效的。计划增加更多复杂练习的虚拟培训模块,以确认这些初步结果。