Baris Mazlum, Schaper Nils von, Weis Hannah Sofie, Fröhlich Klaus, Rustenbach Christian, Herrmann-Werner Anne, Schlensak Christian, Salewski Christoph
Department of Thoracic and Cardiovascular Surgery, University Medical Center Tübingen, Tübingen, Germany.
Medical Faculty, University of Tübingen, Tübingen, Germany.
Med Educ Online. 2025 Dec;30(1):2486976. doi: 10.1080/10872981.2025.2486976. Epub 2025 Apr 8.
This study aims to enhance the confidence and operational safety of 5th-year medical students in the operating room (OR), addressing their corona pandemic gap in surgical training.
We augmented the surgical curriculum focusing on pre-, intra-, and post-operative skills, centered around a phantom operation as a pre-test-retest simulation. We measured confidence to assist in surgery on a 5-level Likert-scale and monitored surgical performance metrics (skin-to-skin time, blood loss, blood and volume transfusion, complications, fatal outcome). Half the cohort was explicitly video trained in hemostasis, while the other half in emergency communication. Factual knowledge gains were assessed with online questionnaires. The groups served as reciprocal controls, as confidence (communication group) and surgical performance (bleeding group) were compared.
Initially, the pre-test performance of the 126 participants on the phantom operation was suboptimal, ranging from poor to mediocre. Notably, the retest outcomes demonstrated significant surgical performance improvements following the targeted lessons (e.g. blood loss pre-test 906 ± 468 mL, retest 292 ± 173 mL, < 0.01, = 35 teams), with the most pronounced enhancements observed in confidence and emergency communication skills (confidence pre-test 2.42 ± 0.52, retest 3.55 ± 0.64, < 0.01, = 35 teams). There is a strong tendency ( = 0.08) that the communication group (1.28 ± 0.53) had higher gains in confidence than the bleeding group (0.997 ± 0.4) with a moderate effect size (Cohen's D = 0.6). Students reported increased confidence in assisting in surgery compared to their initial self-assessments. These results show that the structured exposure to a pre-test-retest phantom operation substantially elevates students' capability to act safely and assertively in the OR.
This approach appears to foster a justified increase in confidence and surgical performance, potentially elevating patient safety among students and residents in training.
本研究旨在增强五年级医学生在手术室（OR）中的信心和操作安全性，弥补他们在新冠疫情期间外科培训的差距。
我们加强了以外科手术前、手术中和手术后技能为重点的外科课程，以模拟手术作为预测试-再测试模拟为核心。我们使用5级李克特量表测量协助手术的信心，并监测手术性能指标（皮肤对皮肤时间、失血量、输血、并发症、致命结果）。一半的队列接受了止血方面的明确视频培训，另一半接受了紧急沟通方面的培训。通过在线问卷评估事实性知识的收获。这些组作为相互对照，比较了信心（沟通组）和手术性能（出血组）。
最初，126名参与者在模拟手术中的预测试表现不尽人意，从差到中等。值得注意的是，再测试结果显示，在接受针对性课程后，手术性能有显著提高（例如，失血量预测试为906±468毫升，再测试为292±173毫升，<0.01，=35个团队），在信心和紧急沟通技能方面提高最为明显（信心预测试为2.42±0.52，再测试为3.55±0.64，<0.01，=35个团队）。有一种强烈的趋势（=0.08），即沟通组（1.28±0.53）在信心方面的提高高于出血组（0.997±0.4），效应大小适中（科恩D=0.6）。与最初的自我评估相比，学生们报告称在协助手术方面信心有所增强。这些结果表明，结构化地接触预测试-再测试模拟手术显著提高了学生在手术室中安全、果断行动的能力。
这种方法似乎促进了信心和手术性能的合理提高，有可能提升学生和住院医师培训期间的患者安全。
