Department of Surgery, Sri Ramachandra Medical College and Research Institute, SRIHER, Chennai, Tamil Nadu, India.
Department of Pediatric Cardiothoracic Surgery, Institute of child health, Madras Medical College, Chennai, Tamilnadu, India.
BMC Med Educ. 2024 Nov 28;24(1):1386. doi: 10.1186/s12909-024-06013-w.
Surgical education necessitates hands-on training, which poses ethical challenges when practicing on real patients. Simulation training emerges as a pivotal solution, offering a safe and effective environment for skill acquisition. However, existing simulation models often overlook common surgical conditions like superficial skin abscesses. The National Medical Commission advocates for simulation-based training in basic surgical skills, highlighting the need for accessible and cost-effective models. Thus, this study aimed to develop and evaluate a novel Indigenous Cost-effective model for Incision & Drainage (NICA) of subcutaneous abscesses, addressing the gap in surgical education.
Following institutional ethics clearance, the study employed Kern's Six-step approach for curriculum development. The NICA model was conceptualized and crafted using locally available, low-cost materials, validated by expert opinion, and implemented in a simulation lab setting. A total of 155 surgical interns underwent training, consisting of didactic video sessions, hands-on practice with the NICA model, and structured assessments. Pre- and post-training evaluations were conducted to measure interns' performance and feedback.
Expert validation confirmed NICA model's fidelity and usefulness. Training 155 surgical interns resulted in significant skill improvements. Pre-training, 33% correctly performed pre-procedural requisites, 46% executed procedural techniques, and 48% performed post-procedural steps accurately. Post-training, these percentages surged to 95%, 97%, and 98%, respectively. Post test score showed significant skill enhancements across all domains (p < 0.05). Intern feedback highlighted increased confidence, satisfaction, and interest in learning, affirming NICA model's effectiveness.
The development and implementation of the NICA model offer a scalable and cost-effective solution for surgical training in resource-limited settings. The model's effectiveness in enhancing interns' skills and confidence underscores its potential to address training needs effectively. The study highlights the significance of simulation-based training in surgical education and advocates for the widespread adoption of indigenous low-cost models to improve surgical skills acquisition.
外科教育需要实践培训，但在真实患者身上进行实践会带来伦理挑战。模拟培训成为一种关键的解决方案，为技能获取提供了安全有效的环境。然而，现有的模拟模型通常忽略了常见的外科情况，如浅表皮肤脓肿。国家医学委员会提倡在基础外科技能中进行基于模拟的培训，强调需要可及且具有成本效益的模型。因此，本研究旨在开发和评估一种新颖的、具有本土成本效益的皮下脓肿切开引流（NICA）模型，以解决外科教育中的空白。
在机构伦理审查通过后，本研究采用 Kern 的六步课程开发方法。NICA 模型的概念化和制作使用了当地可用的低成本材料，经过专家意见验证，并在模拟实验室环境中实施。共有 155 名外科实习医生接受了培训，包括理论视频课程、使用 NICA 模型进行实践操作以及结构化评估。进行了培训前后的评估，以衡量实习医生的表现和反馈。
专家验证证实了 NICA 模型的逼真度和有用性。培训 155 名外科实习医生后，技能显著提高。培训前，只有 33%的实习医生正确完成了术前准备要求，46%的实习医生执行了手术技术，48%的实习医生准确完成了术后步骤。培训后，这些百分比分别飙升至 95%、97%和 98%。后测分数显示所有领域的技能都有显著提高（p<0.05）。实习医生的反馈强调了他们的信心、满意度和学习兴趣的增加，证实了 NICA 模型的有效性。
NICA 模型的开发和实施为资源有限环境中的外科培训提供了一种可扩展且具有成本效益的解决方案。该模型在提高实习医生技能和信心方面的有效性突显了其有效满足培训需求的潜力。该研究强调了模拟培训在外科教育中的重要性，并提倡广泛采用本土低成本模型来提高外科技能的获取。
