Cundiff G W
Division of Gynecologic Specialties, Duke University Medical Center, Durham, North Carolina 27710, USA.
Obstet Gynecol. 1997 Nov;90(5):854-9. doi: 10.1016/S0029-7844(97)00428-6.
To evaluate the effectiveness of a gynecologic endoscopy education program in enhancing residents' proficiency in laparoscopic surgery.
The program was designed to provide residents with the knowledge and skills necessary for laparoscopic surgery, before entering the operating room, in a cost-effective manner that honored the principles of adult education. The 7-week program included didactic sessions to provide conceptual learning but focused on practical skills enhancement through practice in both pelvic trainer and animal laboratory settings. The program design included dominant, nondominant, and two-handed skills as well as models for laparoscopic dissection, hemostasis, and suturing. The evaluation of the program is based on timing of laparoscopic skills as well as resident and faculty evaluation of laparoscopic proficiency at the beginning and end of the program.
Prior to the program, 48% of residents and 75% of faculty were satisfied with laparoscopic training. All residents improved operating times in pelvic trainer skills after the program, with first-year residents improving by 68%, third-year residents by 58%, and fourth-year residents by 72%. The residents self-assessment of competence in 14 laparoscopic skills revealed an increase in all skills following the program. The faculty assessment showed an upward trend in skills competence. At the conclusion of the program, 100% of residents and 92% of faculty were satisfied with the laparoscopic training.
A structured program emphasizing skills enhancement is an effective approach to improve residents' performance in laparoscopic surgery.
评估妇科内镜教育项目在提高住院医师腹腔镜手术熟练程度方面的效果。
该项目旨在以符合成人教育原则且经济高效的方式,在住院医师进入手术室之前,为其提供腹腔镜手术所需的知识和技能。为期7周的项目包括理论课程以提供概念性学习,但重点是通过在盆腔训练器和动物实验室环境中的实践来提高实践技能。项目设计涵盖优势手、非优势手和双手技能,以及腹腔镜解剖、止血和缝合模型。该项目的评估基于腹腔镜技能的操作时间以及项目开始和结束时住院医师和教员对腹腔镜熟练程度的评估。
在项目开展前,48%的住院医师和75%的教员对腹腔镜培训感到满意。项目结束后,所有住院医师在盆腔训练器技能方面的操作时间均有所缩短,一年级住院医师缩短了68%,三年级住院医师缩短了58%,四年级住院医师缩短了72%。住院医师对14项腹腔镜技能的能力自我评估显示,项目结束后所有技能均有所提高。教员评估显示技能能力呈上升趋势。项目结束时,100%的住院医师和92%的教员对腹腔镜培训感到满意。
一个强调技能提升的结构化项目是提高住院医师腹腔镜手术表现的有效方法。