Arthroscopic Shoulder Surgical Simulation Training Curriculum: Transfer Reliability and Maintenance of Skill Over Time

被引:50
作者
Dunn, John C. [1 ]
Belmont, Philip J. [1 ]
Lanzi, Joseph [1 ]
Martin, Kevin [2 ]
Bader, Julia [1 ]
Owens, Brett [3 ]
Waterman, Brian R. [1 ]
机构
[1] William Beaumont Army Med Ctr, Dept Orthopaed Surg & Rehabil, Ft Bliss, TX USA
[2] Evans Army Community Hosp, Dept Orthopaed Surg, Ft Carson, CO USA
[3] Keller Army Community Hosp, Dept Orthopaed Surg, West Point, NY USA
关键词
simulation; surgical training; transfer validity; shoulder; arthroscopy; SURGERY RESIDENCY; MORTALITY;
D O I
10.1016/j.jsurg.2015.06.021
中图分类号
G40 [教育学];
学科分类号
040101 ; 120403 ;
摘要
BACKGROUND: Surgical education is evolving as work hour constraints limit the exposure of residents to the operating room. Potential consequences may include erosion of resident education and decreased quality of patient care. Surgical simulation training has become a focus of study in an effort to counter these challenges. Previous studies have validated the use of arthroscopic surgical simulation programs both in vitro and in vivo. However, no study has examined if the gains made by residents after a simulation program are retained after a period away from training. METHODS: In all, 17 orthopedic surgery residents were randomized into simulation or standard practice groups. All subjects were oriented to the arthroscopic simulator, a 14-point anatomic checklist, and Arthroscopic Surgery Skill Evaluation Tool (ASSET). The experimental group received 1 hour of simulation training whereas the control group had no additional training. All subjects performed a recorded, diagnostic arthroscopy intraoperatively. These videos were scored by 2 blinded, fellowship-trained orthopedic surgeons and outcome measures were compared within and between the groups. After 1 year in which neither group had exposure to surgical simulation training, all residents were retested intraoperatively and scored in the exact same fashion. Individual surgical case logs were reviewed and surgical case volume was documented. RESULTS: There was no difference between the 2 groups after initial simulation testing and there was no correlation between case volume and initial scores. After training, the simulation group improved as compared with baseline in mean ASSET (p = 0.023) and mean time to completion (p = 0.01). After 1 year, there was no difference between the groups in any outcome measurements. CONCLUSION: Although individual technical skills can be cultivated with surgical simulation training, these advancements can be lost without continued education. It is imperative that residency programs implement a simulation curriculum and continue to train throughout the academic year. (Published by Elsevier Inc on behalf of the Association of Program Directors in Surgery)
引用
收藏
页码:1118 / 1123
页数:6
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