Evaluation of Laparoscopic Curricula in American Urology Residency Training: A 5-Year Update
Evaluation of Laparoscopic Curricula in American Urology Residency Training: A 5-Year Update
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DOI：
10.1089/end.2015.0561
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发表时间：
2016-03-01
影响因子：
2.7
通讯作者：
Schenkman, Noah S.
中科院分区：
文献类型：
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作者：
Clements, Matthew B.;Morrison, Kasey Y.;Schenkman, Noah S.
简介/目的：医疗模拟具有提高住院医师技能和舒适度而不影响患者护理的优势。五年前，我们确定了 2008 年和 2009 年美国泌尿外科住院医师培训项目中机器人和腹腔镜模拟的使用趋势。我们试图确定随着技术进步和研究生医学教育的变化，模拟器的使用和正式课程的存在发生的变化。方法：对美国泌尿外科协会 (AUA) 基础科学课程的参加者（大多数是住院医师第二年或第三年）进行了调查，了解他们的课程中腹腔镜/机器人模拟器的可用性和使用情况、正式课程的存在以及关于面部和内容有效性的李克特量表问卷。结果：超过 5 年在此期间，虚拟现实机器人模拟器的可用性从 14% 大幅增加到 2013 年的近 60%。尽管有这种增加，模拟器的使用频率保持不变 (p= 0.40)，并且据报告，正式课程的存在从 41% 下降到 34.8%。在有或没有腹腔镜/机器人课程的项目中，住院医生使用模拟器的情况没有显着差异 (p= 0.95)。认为官方腹腔镜课程 (93%–81%) 和模拟器 (82%–74%) 应参与住院医师教育的住院医师比例也有所下降。 结论：在过去 5 年中，尽管有证据支持模拟器使用的好处和可用性的增加，但住院医师自我报告的使用情况保持不变，并且腹腔镜/机器人课程存在的报告有所减少。通过对正式课程进行更多的专门投资，住院医师培训项目可能会在模拟器投资上获得更大的回报，提高住院医师技能和舒适度，并最终提高患者护理的质量。
Introduction/Purpose:Medical simulation offers the advantage of improving resident skill and comfort without impacting patient care. Five years ago, we identified trends in the use of robotic and laparoscopic simulation in 2008 and 2009 at American urology residency training programs. We seek to identify the changes in the use of simulators and the presence of formal curricula in the wake of technological advances and changes in graduate medical education.Methods:Attendees of the American Urological Association (AUA) Basic Sciences Course, mostly in their second or third year of residency, were surveyed on the availability and use of laparoscopic/robotic simulators at their program, the presence of a formal curriculum, and a Likert scale questionnaire regarding face and content validity.Results:Over a 5-year period, the availability of virtual reality robotic simulators substantially increased from 14% to nearly 60% availability in 2013. Despite this increase, the frequency of simulator use remained unchanged (p= 0.40) and the reported presence of formal curricula decreased from 41% to 34.8%. There was no significant difference in simulator use between residents in programs with or without laparoscopic/robotic curricula (p= 0.95). There was also a decrease in the percentage of residents who felt official laparoscopic curricula (93%–81%) and simulators (82%–74%) should be involved in resident education.Conclusions:In the past 5 years, despite evidence supporting benefits from simulator use and increasing availability, self-reported resident use has remained unchanged and the reporting of presence of laparoscopic/robotic curricula has decreased. With more dedicated investment in formal curricula, residency training programs may receive greater returns on their simulator investments, improve resident skills and comfort, and ultimately improve the quality of patient care.