Teaching surgical skills: What kind of practice makes perfect? A randomized, controlled trial
Teaching surgical skills: What kind of practice makes perfect? A randomized, controlled trial
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DOI：
10.1097/01.sla.0000234808.85789.6a
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发表时间：
2006-09-01
影响因子：
9
通讯作者：
Reznick, Richard
中科院分区：
文献类型：
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作者：
Moulton, Carol-Anne E.;Dubrowski, Adam;Reznick, Richard
目的：外科技能实验室已成为早期技能获取的重要场所。在这种新的教育环境中，管理培训的原则在很大程度上仍然未知;最常见的培训方法，特别是继续医学教育（CME），是一个单一的多小时活动。本研究讨论了另一种方法的影响，其中学习分布在一些培训课程。一个新的技能的收购和转让，以生活般的modelassessed.Methods：38个初级外科住院医生，随机分配到无论是大规模的（1天）或分布（每周）的实践方案，被教导一个新的技能（微血管吻合）。每组在练习中花费的时间相同。在训练前、训练后立即和训练后1个月对性能进行评估。吻合技能的最终测试通过转移到活的麻醉大鼠中进行评估。使用先前验证的基于计算机和基于专家的结果测量。此外，临床相关的结果进行了assessed.Results：两组表现出立即改善的性能，但分布组表现出显着更好的保留测试在大多数结果的措施（时间，手的运动次数，和专家的全球评级;所有P值
Objective: Surgical skills laboratories have become an important venue for early skill acquisition. The principles that govern training in this novel educational environment remain largely unknown; the commonest method of training, especially for continuing medical education (CME), is a single multihour event. This study addresses the impact of an alternative method, where learning is distributed over a number of training sessions. The acquisition and transfer of a new skill to a life-like model is assessed.Methods: Thirty-eight junior surgical residents, randomly assigned to either massed (1 day) or distributed (weekly) practice regimens, were taught a new skill (microvascular anastomosis). Each group spent the same amount of time in practice. Performance was assessed pretraining, immediately post-training, and 1 month posttraining. The ultimate test of anastomotic skill was assessed with a transfer test to a live, anesthetized rat. Previously validated computer-based and expert-based outcome measures were used. In addition, clinically relevant outcomes were assessed.Results: Both groups showed immediate improvement in performance, but the distributed group performed significantly better on the retention test in most outcome measures (time, number of hand movements, and expert global ratings; all P values