Vessel ligation training via an adaptive simulation curriculum.
Vessel ligation training via an adaptive simulation curriculum.
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通过自适应模拟课程进行血管结扎培训。
DOI：
10.1016/j.jss.2015.01.044
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Rasmussen,SaraK
中科院分区：
文献类型：
--
作者：
Hu,Yinin;Goodrich,RobynN;Le,IvyA;Brooks,KendallD;Sawyer,RobertG;Smith,PhilipW;Schroen,AnnekeT;Rasmussen,SaraK
目前缺乏一种成本效益高的开放式血管结扎模型。我们假设一种新颖、廉价的血管结扎模拟器可以有效地向新手传授可转移的手术技能。材料与方法设计vesselbox，以外科手套作为替代血管，模拟血管结扎。四年级医学生使用VesselBox进行结扎，并由外科教师使用客观结构化技术技能评估全球评定量表和任务特定清单进行评估。随后，每个学生在一个累积求和指导的适应性练习环节中使用VesselBox进行训练。后测是由不知道前测结果的评估人员对新鲜的人类尸体进行的。结果16名学生完成了研究。VesselBox练习时间平均为每个参与者21.8分钟（四分位数范围为19.5-27.7）。通过客观结构化技术技能评估（3.23对2.29，P< 0.001）和检查表指标（7.33对4.83，P< 0.001），盲法后测显示熟练程度提高。结扎血管的平均速度从128.2秒提高到97.5秒（P= 0.001）。在这种适应性训练方案后，练习量与测试后的表现无关。结论vesselbox是一种性价比高、保真度低的血管结扎模型，适合医科毕业生和初级住院医师使用。累加和可以促进适应性的、个性化的模拟训练课程。
BackgroundA cost-effective model for open vessel ligation is currently lacking. We hypothesized that a novel, inexpensive vessel ligation simulator can efficiently impart transferrable surgical skills to novice trainees.Materials and methodsVesselBox was designed to simulate vessel ligation using surgical gloves as surrogate vessels. Fourth-year medical students performed ligations using VesselBox and were evaluated by surgical faculty using the Objective Structured Assessments of Technical Skills global rating scale and a task-specific checklist. Subsequently, each student was trained using VesselBox in an adaptive practice session guided by cumulative sum. Posttesting was performed on fresh human cadavers by evaluators blinded to pretest results.ResultsSixteen students completed the study. VesselBox practice sessions averaged 21.8 min per participant (interquartile range 19.5–27.7). Blinded posttests demonstrated increased proficiency, as measured by both Objective Structured Assessments of Technical Skills (3.23versus2.29,P< 0.001) and checklist metrics (7.33versus4.83,P< 0.001). Median speed improved from 128.2 s to 97.5 s per vessel ligated (P= 0.001). After this adaptive training protocol, practice volume was not associated with posttest performance.ConclusionsVesselBox is a cost-effective, low-fidelity vessel ligation model suitable for graduating medical students and junior residents. Cumulative sum can facilitate an adaptive, individualized curriculum for simulation training.
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