Proficiency-based Fundamentals of Laparoscopic Surgery skills training results in durable performance improvement and a uniform certification pass rate
Proficiency-based Fundamentals of Laparoscopic Surgery skills training results in durable performance improvement and a uniform certification pass rate
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DOI：
10.1007/s00464-010-0985-2
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发表时间：
2010-10-01
影响因子：
3.1
通讯作者：
Scott, Daniel J.
中科院分区：
文献类型：
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作者：
Rosenthal, Madelyn E.;Ritter, E. Matt;Scott, Daniel J.
作者之前已经记录了100%的认证合格率后，立即基于熟练的技能培训课程的腹腔镜手术基础（FLS）计划。本研究旨在确定在初始训练后获得的技能的持久性。方法采用机构审查委员会（IRB）批准的方案，选取两所院校的21名医学生作为研究对象。如前所述，所有参与者在2个月的时间里，通过以分布式的方式练习五个FLS任务，成功地完成了基于熟练程度的结构化培训课程。进行了前后测试，并使用了标准的测试度量。参与者在最初的课程完成后6个月（保留1）和1年（保留2）被招募进行重复测试。在最初的21名学生中，有15名（10名来自德克萨斯大学西南分校，5名来自军警大学）愿意参加。参与者没有额外的技能实验室培训和最低限度的临床腹腔镜暴露。结果15名参与者在最初的前测中均未表现出熟练程度（平均得分为146 +/- 65），在后测中表现出显著改善（p < 0.001）（469 +/- 20）。参与者在记忆保留1（437 +/- 39；93%的后测分数保留）和记忆保留2（444 +/- 55；95%的后测分数保留）保持了非常高的水平。他们在两个保留测试间隔中的表现足以让他们轻松地通过认证考试（270分的及格分数线）。两家机构在任何时间点的表现都没有显著差异。结论：以熟练程度为基础的FLS技能课程可靠地导致了高水平的技能保留，即使在缺乏持续的模拟器培训或临床经验的情况下。这个课程适合广泛实施。
Background The authors have previously documented a 100% certification pass rate immediately after a proficiency-based skills training curriculum for the Fundamentals of Laparoscopic Surgery (FLS) program. This study aimed to determine the durability of skills acquired after initial training.Methods For this study, 21 novice medical students were enrolled in institutional review board (IRB)-approved protocols at two institutions. As previously reported, all the participants successfully completed a structured proficiency-based training curriculum by practicing the five FLS tasks in a distributed fashion over a 2-month period. Pre- and posttesting was conducted, and standard testing metrics were used. The participants were recruited for repeat testing 6 months (retention 1) and 1 year (retention 2) after initial curriculum completion. Of the original 21 students, 15 (10 at University of Texas Southwestern and 5 at Uniformed Services University) were available and agreed to participate. The participants had no additional skills lab training and minimal clinical laparoscopic exposure.Results None of the 15 participants demonstrated proficiency at the initial pretest (mean score, 146 +/- 65), and performance showed significant improvement (p < 0.001) at the posttest (469 +/- 20). The participants retained a very high level of performance at retention 1 (437 +/- 39; 93% retention of the posttest score) and retention 2 (444 +/- 55; 95% retention of the posttest score). Their performance at both retention testing-intervals was sufficient for passing the certification exam (270 cutoff score for passing) with a comfortable margin. There were no significant differences in performance between the two institutions at any time points.Conclusion The proficiency-based FLS skills curriculum reliably results in a high level of skill retention, even in the absence of ongoing simulator-based training or clinical experience. This curriculum is suitable for widespread implementation.