Arthroscopy Skills Development With a Surgical Simulator: A Comparative Study in Orthopaedic Surgery Residents
Arthroscopy Skills Development With a Surgical Simulator: A Comparative Study in Orthopaedic Surgery Residents
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DOI：
10.1177/0363546515574064
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发表时间：
2015-06-01
影响因子：
4.8
通讯作者：
Ranawat, Anil S.
中科院分区：
文献类型：
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作者：
Rebolledo, Brian J.;Hammann-Scala, Jennifer;Ranawat, Anil S.
背景：手术模拟与骨科手术教育的关系越来越密切，可以转化为提高骨科手术学员的手术室熟练程度。目的：比较接受膝关节肩关节镜手术模拟器训练的初级骨科住院医师与接受说教式训练的住院医师的关节镜表现。研究设计：实验室对照研究。方法：将同一医院的14名初级骨科住院医师随机分为两组，一组使用手术模拟器进行膝关节和肩关节镜训练（n = 8），另一组使用关节镜模型进行授课（n = 6）。在各自的训练后，使用尸体模型评估诊断膝关节和肩关节镜的表现。然后使用主观损伤分级指数（评分，1-10）评估关节镜处理的完成时间和评估，以评估最终尸体测试的表现。结果：在肩关节镜手术完成时间（-35%,P = 0.02）和损伤分级指数（-35%,P = 0.01）方面，使用手术模拟器训练的骨科住院医师优于教学训练的住院医师。此外，从完成时间（-36%,P = 0.09）和损伤分级指数（P = 0.08）来看，模拟训练组的膝关节镜检查表现有改善的趋势。结论：在本研究中，接受手术模拟器训练的初级骨科住院医师在膝关节和肩关节镜检查中表现出改善。然而，对骨科住院医师进行外科模拟器培训的未来验证仍有必要。临床意义：关节镜手术模拟器的手术技能发展可以转化为手术室中关节镜检查表现的改善。
Background: Surgical simulation has become increasingly relevant to orthopaedic surgery education and could translate to improved operating room proficiency in orthopaedic surgery trainees.Purpose: To compare the arthroscopic performance of junior orthopaedic surgery residents who received training with a knee and shoulder arthroscopy surgical simulator with those who received didactic training.Study Design: Controlled laboratory study.Methods: Fourteen junior orthopaedic surgery residents at a single institution were randomized to receive knee and shoulder arthroscopy training with a surgical simulator (n = 8) or didactic lectures with arthroscopy models (n = 6). After their respective training, performance in diagnostic knee and shoulder arthroscopy was assessed using a cadaveric model. Time to completion and assessment of arthroscopic handling using a subjective injury grading index (scale, 1-10) was then used to evaluate performance in final cadaveric testing.Results: Orthopaedic surgery residents who trained with a surgical simulator outperformed the didactic-trained residents in shoulder arthroscopy by time to completion (-35%; P = .02) and injury grading index (-35%; P = .01). In addition, a trend toward improved performance of knee arthroscopy by the simulator-trained group was found by time to completion (-36%; P = .09) and injury grading index (P = .08).Conclusion: In this study, junior orthopaedic surgery residents who trained with a surgical simulator demonstrated improved arthroscopic performance in both knee and shoulder arthroscopy. However, future validation of surgical simulator training for orthopaedic surgery residents remains warranted.Clinical Relevance: Surgical skill development with an arthroscopy surgical simulator could translate to improved arthroscopy performance in the operating room.