Effective home laparoscopic simulation training: a preliminary evaluation of an improved training paradigm
Effective home laparoscopic simulation training: a preliminary evaluation of an improved training paradigm
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DOI：
10.1016/j.amjsurg.2011.07.001
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发表时间：
2012-01-01
影响因子：
3
通讯作者：
Downing, Steven M.
中科院分区：
文献类型：
--
作者：
Korndorffer, James R., Jr.;Bellows, Charles F.;Downing, Steven M.
背景：腹腔镜模拟训练已被证明在培养技能方面是有效的，但需要昂贵的设备，融入工作时间受限的外科住院医师是一个挑战，并且可能使用非最佳实践时间表。本研究的目的是评估在家中使用廉价的教练箱进行腹腔镜术技能培训的效果。方法：住院医生(n=20，研究生1-5年)参加机构评审委员会批准的腹腔镜术技能培训方案。回顾了一段教学视频，并使用腹腔镜手术(FLS)钉转移和缝合任务的基本原理进行了基线测试。参与者被随机分配到价格低廉、设备齐全的训练箱进行家庭训练，或者使用标准视频训练器到模拟中心进行训练。鼓励每周至少1小时的自由支配的、目标导向的培训。进行了后测和保持试验。组内和组间比较，以及缝合分数与总训练时间、训练时间和尝试次数之间的关系。结果：组内比较显示，从基线到后测和保持测验，组内比较有显著改善。两组之间没有显示出差异。家庭训练组的练习次数更多，且会话次数与缝线保留分数相关(r(2)=.54，P<；.039)。结论：家庭训练可促进腹腔镜术技能的获得和保留。培训以更分散的方式进行，并有提高技能留存的趋势。(C)2012 Elsevier Inc.保留所有权利。
BACKGROUND: Laparoscopic simulation training has proven to be effective in developing skills but requires expensive equipment, is a challenge to integrate into a work-hour restricted surgical residency, and may use nonoptimal practice schedules. The purpose of this study was to evaluate the efficacy of laparoscopic skills training at home using inexpensive trainer boxes.METHODS: Residents (n = 20, postgraduate years 1-5) enrolled in an institutional review board-approved laparoscopic skills training protocol. An instructional video was reviewed, and baseline testing was performed using the fundamentals of laparoscopic surgery (FLS) peg transfer and suturing tasks. Participants were randomized to home training with inexpensive, self-contained trainer boxes or to simulation center training using standard video trainers. Discretionary, goal-directed training of at least 1 hour per week was encouraged. A posttest and retention test were performed. Intragroup and intergroup comparisons as well as the relationship between the suture score and the total training sessions, the time in training, and attempts were studied.RESULTS: Intragroup comparisons showed significant improvement from baseline to the posttest and the retention test. No differences were shown between the groups. The home-trained group practiced more, and the number of sessions correlated with suture retention score (r(2) = .54, P < .039).CONCLUSIONS: Home training results in laparoscopic skill acquisition and retention. Training is performed in a more distributed manner and trends toward improved skill retention. (C) 2012 Elsevier Inc. All rights reserved.