Training Surgeons to Perform Arthroscopic All-Inside Meniscal Repair: A Randomized Controlled Trial Evaluating the Effectiveness of a Novel Cognitive Task Analysis Teaching Tool, Imperial College London/University College London Meniscus Repair Cognitive Task Analysis (IUMeRCTA).
Training Surgeons to Perform Arthroscopic All-Inside Meniscal Repair: A Randomized Controlled Trial Evaluating the Effectiveness of a Novel Cognitive Task Analysis Teaching Tool, Imperial College London/University College London Meniscus Repair Cognitive Task Analysis (IUMeRCTA).
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DOI：
10.1177/03635465211021652
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Gupte C
中科院分区：
文献类型：
--
作者：
Karamchandani U;Bhattacharyya R;Patel R;Oussedik S;Bhattacharya R;Gupte C
全内半月板修复术是一种越来越常见的手术治疗半月板撕裂的技术。目前还没有标准化的技术来培训住院医师进行该手术。认知任务分析（CTA）是一种分析和标准化程序中的关键步骤的方法，允许以有效和可重复的方式进行培训。(1)设计一种标准化全内修复CTA数字化教学工具。(2)评估与接受传统学徒培训方法的对照组相比，CTA培训的住院医师是否能更好地完成髋关节修复任务。对照实验室研究。采用改良的德尔菲法对三位膝关节外科专家进行了访谈，以就全内固定修复术的理想技术步骤、认知决策点、常见错误和解决方案达成共识。然后将这些书面信息与视觉和音频组件相结合，并集成到数字平台上，以创建帝国理工学院伦敦/伦敦大学学院伦敦半月板修复认知任务分析（IUMeRCTA）工具。将18名新手住院医师随机分为干预组（数字CTA工具）和对照组（设备说明书）。两组均在高保真、体模膝关节模型上进行全内半月板修复，并由专家外科医生使用经验证的全球评级量表（GRS）进行评估，对干预措施不知情。功效计算后，使用Mann-Whitney U检验比较组间的中值GRS评分;显著性设定为P <0.05。对于IUMeRCTA工具设计，手术分为9个阶段的55个步骤：（1）术前计划，（2）手术室和患者设置，（3）入路放置，（4）尿道检查，（5）撕裂减少，（6）缝线计划，（7）缝线插入，（8）修复完成，（9）术后护理和康复。在试验中，干预组（平均值± SD GRS，32 ± 2.9）的表现明显优于对照组（GRS，24 ± 3.3; P <0.001）。这是第一个证明培训新手进行关节镜下全内半月板修复的客观受益的CTA工具。IUMeRCTA工具是传统教学的一种易于使用和有效的辅助工具，可增强新手外科医生对全内修复的学习。
All-inside meniscal repair is an increasingly common technique for the surgical treatment of meniscal tears. There are currently no standardized techniques for training residents in this procedure. Cognitive task analysis (CTA) is a method of analyzing and standardizing key steps in a procedure that allows training to be conducted in a validated and reproducible manner. (1) To design a digital CTA teaching tool for a standardized all-inside meniscal repair. (2) To evaluate whether CTA-trained residents would perform better in a meniscal repair task compared with a control group who underwent traditional apprenticeship methods of training. Controlled laboratory study. Three expert knee surgeons were interviewed using a modified Delphi method to generate a consensus among the ideal technical steps, cognitive decision points, and common errors and solutions for an all-inside meniscal repair. This written information was then combined with visual and audio components and integrated onto a digital platform to create the Imperial College London/University College London Meniscus Repair Cognitive Task Analysis (IUMeRCTA) tool. Eighteen novice residents were randomized into an intervention group (digital CTA tool) and control group (equipment instruction manual). Both groups performed an all-inside meniscal repair on high-fidelity, phantom knee models and were assessed by expert surgeons, blinded to the interventions, using a validated global rating scale (GRS). After a power calculation, median GRS scores were compared between groups using the Mann-Whitney U test; significance was set at P < .05. For the IUMeRCTA tool design, the procedure was divided into 55 steps across 9 phases: (1) preoperative planning, (2) theater and patient setup, (3) portal placement, (4) meniscal examination, (5) tear reduction, (6) suture planning, (7) suture insertion, (8) repair completion, and (9) postoperative care and rehabilitation. For the trial, the intervention group (mean ± SD GRS, 32 ± 2.9) performed significantly better than did the control group (GRS, 24 ± 3.3; P < .001). This is the first CTA tool to demonstrate objective benefits in training novices to perform an arthroscopic all-inside meniscal repair. The IUMeRCTA tool is an easily accessible and effective adjunct to traditional teaching that enhances learning the all-inside meniscal repair for novice surgeons.
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影响因子：
4.2
作者：
Harris, Joshua D.;Staheli, Greg;McCormick, Frank
通讯作者：
McCormick, Frank
影响因子：
2.2
作者：
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通讯作者：
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影响因子：
3.7
作者：
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通讯作者：
Gupte CM
影响因子：
3
作者：
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通讯作者：
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影响因子：
4.8
作者：
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通讯作者：
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