Telesimulation: an effective method for teaching the fundamentals of laparoscopic surgery in resource-restricted countries
Telesimulation: an effective method for teaching the fundamentals of laparoscopic surgery in resource-restricted countries
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DOI：
10.1007/s00464-009-0572-6
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发表时间：
2010-02-01
影响因子：
3.1
通讯作者：
Azzie, Georges
中科院分区：
文献类型：
--
作者：
Okrainec, Allan;Henao, Oscar;Azzie, Georges
在资源有限的国家开展腹腔镜技能培训存在若干挑战，包括导师需要长途跋涉进行现场教学。远程仿真（TS）是一个新的概念，它使用互联网连接模拟器之间的教练和学员在不同的位置。本研究的目的是确定远程模拟教学的腹腔镜手术（FLS）的基础知识，在非洲博茨瓦纳的外科医生。共16名外科医生来自博茨瓦纳的两个中心参加了这项为期8周的研究。使用两个模拟器、计算机、网络摄像头和Skype（TM）软件为TS组中的八名外科医生设置FLS TS。自我实践（SP）组的8名外科医生可使用标准FLS模拟器。TS组的参与者每周与多伦多大学的FLS普罗克特进行一次远程培训，他提供反馈并展示了适当的技术。SP组的参与者可以获得FLS DVD，并被指示每周至少进行一次FLS培训。FLS后测试分数由一名经过训练的FLS普罗克特在博茨瓦纳获得，TS组的参与者的测试后FLS分数显著高于SP组（440 +/- A 56 vs. 272 +/- A 95，p = 0.001）。TS组的所有学员都获得了FLS模拟器认证合格分数，而SP组只有38%的学员获得了FLS模拟器认证合格分数（p = 0.03）。远程远程模拟是非洲腹腔镜手术基础教学的有效方法，FLS技能合格率达到100%。该培训平台为资源有限的国家提供了一种具有成本效益的教学方法，可用于在世界任何地方通过互联网访问教授腹腔镜技能。
Several challenges exist with laparoscopic skills training in resource-restricted countries, including long travel distances required by mentors for onsite teaching. Telesimulation (TS) is a novel concept that uses the internet to link simulators between an instructor and a trainee in different locations. The purpose of this study was to determine the effectiveness of telesimulation for teaching the Fundamentals of Laparoscopic Surgery (FLS) to surgeons in Botswana, Africa.A total of 16 surgeons from two centers in Botswana participated in this 8-week study. FLS TS was set up using two simulators, computers, webcams, and Skype (TM) software for eight surgeons in the TS group. A standard FLS simulator was available for the eight surgeons in the self-practice (SP) group. Participants in the TS group had one remote training session per week with an FLS proctor at the University of Toronto who provided feedback and demonstrated proper technique. Participants in the SP group had access to the FLS DVD and were instructed to train on FLS at least once per week. FLS post-test scores were obtained in Botswana by a trained FLS proctor at the conclusion of the study.Participants in the TS group had significantly higher post-test FLS scores than those in the SP group (440 +/- A 56 vs. 272 +/- A 95, p = 0.001). All trainees in the TS group achieved an FLS simulator certification passing score, whereas only 38% in the SP group did so (p = 0.03).Remote telesimulation is an effective method for teaching the Fundamentals of Laparoscopic Surgery in Africa, achieving a 100% FLS skills pass rate. This training platform provides a cost-effective method of teaching in resource-restricted countries and could be used to teach laparoscopic skills anywhere in the world with internet access.