Evolution of surgical skills training
Evolution of surgical skills training
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DOI：
10.3748/wjg.v12.i20.3219
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发表时间：
2006-05-28
影响因子：
4.3
通讯作者：
Duffy, Andrew J.
中科院分区：
文献类型：
--
作者：
Roberts, Kurt E.;Bell, Robert L.;Duffy, Andrew J.
外科培训正在发生变化：一百年的传统正在受到患者安全、工作时间限制、手术室时间成本和并发症等法律和道德问题的挑战。手术模拟和技能培训提供了在手术室环境之外教授和练习高级技能的机会，然后再对活体患者进行尝试。模拟培训可以像使用真实仪器和视频设备操作盒子训练器中的模拟“组织”一样直接。更先进的虚拟现实模拟器现已上市，可供广泛使用。早期的系统已经证明了它们的有效性和区分能力。较新的系统能够开发综合课程和完整的程序模拟。研究生医学教育认证委员会 (ACGME) 已要求开发新颖的培训和评估方法。外科组织正在呼吁寻找方法来确保维持技能、推进外科培训并认证外科医生的技术能力。目前形式的模拟器已被证明可以提高外科住院医师的手术室表现。制定标准化培训课程仍然是一个紧迫而重要的议程，特别是对于微创手术而言。借鉴航空领域的经验，创新和进步的方法可以为下个世纪的外科培训奠定基础，确保产品的质量。随着技术的发展，我们的实践方式将不断发展，以造福医生和患者。 (C) 2006 年 WJG 出版社。版权所有。
Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients.Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated "tissue" in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations.The Accreditation Council of Graduate Medical Education's (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent.Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients. (C) 2006 The WJG Press. All rights reserved.