Microvascular anastomosis simulation using a chicken thigh model: Interval versus massed training
Microvascular anastomosis simulation using a chicken thigh model: Interval versus massed training
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DOI：
10.1002/lary.26586
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发表时间：
2017-11-01
期刊：
影响因子：
2.6
通讯作者：
Shonka, David C., Jr.
中科院分区：
文献类型：
--
作者：
Schoeff, Stephen;Hernandez, Brian;Shonka, David C., Jr.
目的/假设比较在经过验证的显微外科模型上教授耳鼻喉科住院医师微血管缝合时集中训练与间歇训练的有效性。研究设计耳鼻喉科住院医师被分为间歇训练组（n = 7）或集中训练组（n = 7）。间歇组进行了 3 次 30 分钟的单独练习，间隔至少 1 周，集中组进行了一次 90 分钟的练习。在第一次训练之前，两组人员都观看了视频演示并录制了预测试。最后一次练习后进行了后测。方法在一个学术医疗中心，14 名耳鼻喉科住院医师采用分层随机分配方式进行间歇或集中训练。盲法评估人员使用经过验证的微血管客观结构化技术技能评估工具对表现进行分级。该工具由两个主要部分组成：特定任务评分（TSS）和总体评分量表（GRS）。参与者还接受了研究前和研究后调查，以比较对微血管技能获取的多个方面的主观信心。结果总体而言，所有住院医师在测试后与测试前相比均表现出更高的 TSS 和 GRS。训练完成后，间歇组的TSS和GRS都有统计学上显着的增加，而集中组的增加并不显着。两组住院医师在完成研究后均报告信心水平显着提高。 结论 使用鸡大腿动脉模型进行自我导向学习可能有利于住院医师的显微外科技能、能力和信心。间歇训练可以显着改善微血管吻合技能的早期发展，而集中训练则不能。证据水平不适用。喉镜，127：2490-2494，2017
Objectives/HypothesisTo compare the effectiveness of massed versus interval training when teaching otolaryngology residents microvascular suturing on a validated microsurgical model.Study DesignOtolaryngology residents were placed into interval (n = 7) or massed (n = 7) training groups. The interval group performed three separate 30-minute practice sessions separated by at least 1 week, and the massed group performed a single 90-minute practice session. Both groups viewed a video demonstration and recorded a pretest prior to the first training session. A post-test was administered following the last practice session.MethodsAt an academic medical center, 14 otolaryngology residents were assigned using stratified randomization to interval or massed training. Blinded evaluators graded performance using a validated microvascular Objective Structured Assessment of Technical Skill tool. The tool is comprised of two major components: task-specific score (TSS) and global rating scale (GRS). Participants also received pre- and poststudy surveys to compare subjective confidence in multiple aspects of microvascular skill acquisition.ResultsOverall, all residents showed increased TSS and GRS on post- versus pretest. After completion of training, the interval group had a statistically significant increase in both TSS and GRS, whereas the massed group's increase was not significant. Residents in both groups reported significantly increased levels of confidence after completion of the study.ConclusionsSelf-directed learning using a chicken thigh artery model may benefit microsurgical skills, competence, and confidence for resident surgeons. Interval training results in significant improvement in early development of microvascular anastomosis skills, whereas massed training does not.Level of EvidenceNA. Laryngoscope, 127:2490-2494, 2017