A Modern Approach to Teaching Pancreatic Surgery
A Modern Approach to Teaching Pancreatic Surgery
复制标题
胰腺外科教学的现代方法
DOI：
--
复制
发表时间：
2012
影响因子：
3.2
通讯作者：
A. Smith
中科院分区：
文献类型：
--
作者：
G. Marangoni;G. Morris;Sunita R. Deshmukh;A. Hakeem;A. Smith
胰腺切除术（PD）一直被认为是技术要求最高的腹部手术之一，即使在高容量中心由经验丰富的外科医生进行。高级外科实习生工作时间的减少导致暴露减少，因此手术经验减少。此外，受训者也成为受害者，因为努力提高手术室效率的卫生保健系统试图通过以培训为代价鼓励顾问主导的手术来减少手术持续时间。因此，需要制定一项战略，使受训者的能力与外科手术的复杂性相匹配。由于PD可以分解为许多不同的步骤，它可能确实是一个理想的训练操作为不同水平的能力。方法我们描述了我们的技术为PD和打破它分为九个步骤的不同技术能力，使其适用于许多不同阶段的外科培训。结果的复杂性和多样性所需的步骤执行PD使其成为一个理想的培训操作，从初级外科实习生，最资深的研究员，允许广泛的技能集的发展。讨论自从引入减少工作时间（48小时每周在欧洲和80小时每周在美国）的“学徒”模式的外科培训已经转向一个时间有限的计划，更强调监督。由于手术的复杂性，以及受训者能力水平降低的感觉，PD通常被视为顾问级手术。我们相信PD是一个很好的模式，因为它为具有不同手术经验的学员提供了机会，因此PD可以被视为理想的“教学案例”。将PD分解为许多不同的步骤可能有助于更快地建立手术专业知识，同时维护患者的安全并允许及时加速手术。
IntroductionPancreatoduodenectomy (PD) has always been regarded as one of the most technically demanding abdominal procedures, even when carried out in high-volume centers by experienced surgeons. The reduction in higher surgical trainees working hours has led to reduced exposure, and consequently less experience in operative procedures. Furthermore, trainees have also become victims as health care systems striving for operating room efficiency, have attempted to reduce procedure duration by encouraging consultant led procedures at the expense of training. A strategy therefore needs to be developed to match the ability of the trainee with the complexity of the surgical procedure. As a PD can be deconstructed into a number of different steps, it may indeed be an ideal training operation for varying levels of ability.MethodsWe describe our technique for PD and break it down to nine steps of varying technical ability making it suitable for many different stages of surgical training.ResultsThe complexity and variety of steps required to perform a PD makes it an ideal training operation from the junior surgical trainee to the most senior fellow, allowing the development of a wide range of skill sets.DiscussionSince the introduction of reduced working hours (48 h per week in Europe and 80 h per week in the USA) the “apprenticeship” model of surgical training has shifted towards a time-limited program with greater emphasis on supervision. Due to the complexity of surgery, and the perception of diminished levels of trainees’ competency, a PD is often viewed as a consultant level operation. We believe that PD is an excellent model as it provides opportunities for trainees with varying levels of operative experience so that a PD could be considered the ideal “teaching case”. Breaking down PD into a number of different steps may help building up surgical expertise more quickly while maintaining patients’ safety and allowing the surgery to be expedited in a timely manner.
影响因子：
9
作者：
Yeo, CJ;Cameron, JL;Abrams, RA
通讯作者：
Abrams, RA