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实习外科医生手术技能实验室的开发与评估:明斯特大学医院的十年经验

Development and evaluation of a surgical skills lab for trainee surgeons: a 10-year experience at the Münster University Hospital.

作者信息

Mohr Annika, Hölzen Jens Peter, Stöppeler Sandra, Spiegel Hans-Ullrich, Palmes Daniel, Bahde Ralf, Kebschull Linus, Juratli Mazen A, Strücker Benjamin, Pascher Andreas, Becker Felix

机构信息

Department of General, Visceral and Transplant Surgery, University Hospital Münster, Waldeyerstr 1, Münster, 48149, Germany.

出版信息

BMC Med Educ. 2025 Apr 4;25(1):484. doi: 10.1186/s12909-025-07064-3.

Abstract

BACKGROUND

Surgical training persists of intensive work, incessant practice, and, most importantly, experience. Owing to the changing surgical environment, increasing specialization, and rapid development of minimally invasive techniques, new innovative approaches in surgical training are necessary to achieve excellent postgraduate education. Here, we introduce a surgical skills lab that offers a multi-course program featuring a concise, modular curriculum comprising well-defined and simple-to-follow procedures, progressively moving surgical techniques from ex vivo to in vivo settings. The evaluation of the course was conducted by analyzing the participants' self-assessment before and after the course.

METHODS

Over the time of ten years, we conducted one-day surgical training courses covering basic surgical techniques, gastrointestinal anastomosis, visceral resection techniques, and techniques in vascular surgery with a total of 348 participants. To assess differences in the self-evaluation of surgical skills before and after each course, a questionnaire (non-validated self-report 5-point Likert scale) was administered to each participant. Results were analyzed with t-test for paired samples.

RESULTS

Before the course, most participants had no practical knowledge of most exercises, and major help was needed. However, after training, the majority of participants were able to perform the surgical techniques independently with little or no assistance. Moreover, a statistical analysis comparing pre- and post-course self-assessment scores for surgical skills revealed significant improvements (p < 0.05) after the course.

CONCLUSION

During the one-day course, it was possible to teach and perform diverse surgical procedures under the guidance of experienced surgeons. The independent reproducibility of the learned material after the course is not yet known, therefore, further investigation is necessary to provide additional information to improve the program. However, with this step-by-step training, we were able to conduct a successful teaching program, shown by the fact that the participants showed significant improvement. Thus, the training presented in this study can serve as a guide for teaching surgical skills outside of the operating room.

摘要

背景

外科培训需要高强度的工作、持续不断的练习,最重要的是经验。由于外科手术环境的变化、专业化程度的提高以及微创技术的快速发展,外科培训需要新的创新方法来实现卓越的研究生教育。在此,我们介绍一个外科技能实验室,该实验室提供一个多课程项目,其特点是课程简洁、模块化,包含定义明确且易于遵循的程序,将手术技术逐步从体外环境过渡到体内环境。通过分析参与者在课程前后的自我评估来对该课程进行评估。

方法

在十年时间里,我们举办了为期一天的外科培训课程,内容涵盖基本外科技术、胃肠吻合术、内脏切除术以及血管外科技术,共有348名参与者。为了评估每门课程前后外科技能自我评估的差异,我们向每位参与者发放了一份问卷(未经验证的自我报告5点李克特量表)。结果采用配对样本t检验进行分析。

结果

课程开始前,大多数参与者对大多数练习没有实际操作知识,需要大量帮助。然而,培训后,大多数参与者能够在很少或无需帮助的情况下独立完成手术技术操作。此外,对课程前后外科技能自我评估得分进行的统计分析显示,课程结束后有显著提高(p < 0.05)。

结论

在为期一天的课程中,在经验丰富的外科医生指导下能够教授和实施多种外科手术。课程结束后所学内容的独立再现性尚不清楚,因此,需要进一步研究以提供更多信息来改进该项目。然而,通过这种循序渐进的培训,我们成功开展了一个教学项目,参与者有显著进步这一事实就证明了这一点。因此,本研究中介绍的培训可作为手术室之外教授外科技能的指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/307f/11971789/e5384607fe34/12909_2025_7064_Fig1_HTML.jpg

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