The impact of objective assessment and constructive feedback on improvement of laparoscopic performance in the operating room
The impact of objective assessment and constructive feedback on improvement of laparoscopic performance in the operating room
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DOI：
10.1007/s00464-007-9356-z
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发表时间：
2007-12-01
影响因子：
3.1
通讯作者：
Kristiansen, Viggo B.
中科院分区：
文献类型：
--
作者：
Grantcharov, Teodor P.;Schulze, Svend;Kristiansen, Viggo B.
目的：进行了这项研究，以证明评估和建设性的反馈对改善腹腔镜手术室（OR）的性能的影响。设计：16名外科实习生进行了腹腔镜胆囊切除术的OR。然后，参与者被分成两组。由经验丰富的外科医生对第1组进行的手术进行评估，并向每位受训者提供详细和建设性的反馈。第二组没有收到任何反馈。随后，所有受试者在手术室进行了新的腹腔镜胆囊切除术。两个手术过程都记录在录像带上，并由两个独立的和盲目的观察者使用一个有效的评分system.Main结果measures：错误和经济的运动评分评估在腹腔镜手术中的OR.Results：两组之间的基线评估无差异（t检验，p > 0.5）。接受反馈的外科医生（第1组）在完成以下手术的时间上取得了显著的改善（独立样本t检验，p = 0.022），误差（t检验，p = 0.003）和运动经济性评分（t检验，p < 0.001）。与对照组相比，接受建设性反馈的外科医生在手术室的表现有了更大的改善。该研究提供了客观证据，表明评估有利于外科培训，并应在未来的教育计划中实施。
Objectives: The study was carried out to demonstrate the impact of assessment and constructive feedback on improvement of laparoscopic performance in the operating room (OR).Design: Sixteen surgical trainees performed a laparoscopic cholecystectomy in the OR. The participants were then divided into two groups. The procedure performed by group 1 was assessed by an experienced surgeon, and detailed and constructive feedback was provided to each trainee. Group 2 received no feedback. Subsequently, all subjects performed a new laparoscopic cholecystectomy in the OR. Both operative procedures were recorded on videotapes and assessed by two independent and blinded observers using a validated scoring system.Main outcome measures: Error and economy of movements score assessed during the laparoscopic procedures in the OR.Results: No differences in baseline assessments were found between the two groups (t-test, p > 0.5). Surgeons, who received feedback (group 1) made significantly greater improvement in their time to complete the following procedure (independent sample t-test, p = 0.022), error (t-test, p = 0.003) and economy of movement scores (t-test, p < 0.001).Conclusions: Surgeons who received constructive feedback made significantly greater improvement in their performance in the OR compared with those in the control group. The study provides objective evidence that assessment is beneficial for surgical training and should be implemented in the educational programmes in the future.