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微创手术中的外科培训模拟模式:如何通过转化研究实现循证课程。

Surgical training simulation modalities in minimally invasive surgery: How to achieve evidence-based curricula by translational research.

作者信息

Seeger Philipp, Kaldis Nikolaos, Nickel Felix, Hackert Thilo, Lykoudis Panagis M, Giannou Anastasios D

机构信息

Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

3rd Department of Surgery, Attiko University Hospital, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Am J Surg. 2025 Apr;242:116197. doi: 10.1016/j.amjsurg.2025.116197. Epub 2025 Jan 17.

Abstract

BACKGROUND

Surgery has evolved from a hands-on discipline where skills were acquired via the "learning by doing" principle to a surgical science with attention to patient safety, health care effectiveness and evidence-based research. A variety of simulation modalities have been developed to meet the need for effective resident training. So far, research regarding surgical training for minimally invasive surgery has been extensive but also heterogenous in grade of evidence.

METHODS

A literature search was conducted to summarize current knowledge about simulation training and to guide research towards evidence-based curricula with translational effects. This was conducted using a variety of terms in PubMed for English articles up to October 2024. Results are presented in a structured narrative review.

RESULTS

For virtual reality simulators, there is sound evidence for effective training outcomes. The required instruments for the development of minimally invasive surgery curricula combining different simulation modalities to create a clinical benefit are known and published.

CONCLUSION

Surgeons are the main creators for minimally invasive surgery training curricula and often follow a hands-on oriented approach that leaves out equally important aspects of assessment, evaluation, and feedback. Further high-quality research that includes available evidence in this field promises to improve patient safety in surgical disciplines.

摘要

背景

外科学已从一门通过“边做边学”原则获取技能的实践学科发展成为一门关注患者安全、医疗保健效果和循证研究的外科学科。为满足住院医师有效培训的需求,已开发出多种模拟方式。到目前为止,关于微创手术外科培训的研究虽然广泛,但证据等级也参差不齐。

方法

进行文献检索以总结有关模拟培训的当前知识,并指导开展具有转化效应的循证课程研究。这是通过在PubMed中使用多种检索词检索截至2024年10月的英文文章来进行的。结果以结构化叙述性综述的形式呈现。

结果

对于虚拟现实模拟器,有充分证据表明其培训效果良好。开发结合不同模拟方式以产生临床效益的微创手术课程所需的器械是已知的且已发表。

结论

外科医生是微创手术培训课程的主要创造者,且通常采用以实践为导向的方法,而忽略了评估、评价和反馈等同样重要的方面。该领域进一步纳入现有证据的高质量研究有望提高外科手术学科的患者安全性。

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