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首页> 外文期刊>The Internet Journal of Medical Simulation >Simulation In Surgery:A Proposal For Quality Control In The Use Of Simulators In Surgical Training
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Simulation In Surgery:A Proposal For Quality Control In The Use Of Simulators In Surgical Training

机译：手术中的模拟：在手术训练中使用模拟器进行质量控制的建议

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Simulation is a concept that has been employed in numerous fields including that of defense, aviation and recently surgery. Simulation seems to hold the answer to several of the challenges faced within the field of surgery. In this study the author reviews the history of simulator use in surgery and then reviews the various applications of simulators in surgery. This will set the foundation to the objective of this study, which is the utility of simulation as a tool in the domain of surgical education (i.e. for training and assessing trainee surgeons). Much of the literature has tended to focus on the design, validity and reliability of simulators, the development of curricula incorporating simulators, and criteria for being regarded as a competent surgeon, in a mutually exclusive manner. [ii],[iii], [iv] This study will attempt to demonstrate that each of these aspects has an order of inter-relationship to one another. This proposed model of inter-relationship will enable us to gain new insights into how the links between them affect one another. The observation of this order will firstly enable a more effective application of simulators as a tool for training future surgeons. Secondly, it will serve to avoid quality control debacles which may occur with the introduction of new technology, the prime example of this being the laparoscopic cholecystectomy fiasco that resulted in a dramatic rise in bile duct injuries in the 1990s.[v] Finally, the author will also demonstrate how continual feedback within this model enables continuous fine-tuning of the system. Satava RM. Historical review of surgical simulation – a personal perspective. World J Surg 2008; 32: 141-148.[ii] McClusky DA, Smith CD.Design and development of a surgical skills simulation curriculum. World J Surg 2008; 32: 171-181.[iii] Aucar JA, Nicholas RG, Troxel SA et al.A review of surgical simulation with attention to validation methodology. Surg Laparosc endosc percutan tech 2005; 15(2): 82-89.[iv] Sarker SK, Patel B. Simulation and surgical training. Int J Clin Pract 2007; 61(12): 2120-2125.[v] Wanzel KR, Ward M, Reznick RK. Teaching the surgical craft: from selection to certification. Curr Probl Surg 2002; 39: 573-660. Introduction As technology evolves at a rapid pace, the field of surgery which is becoming more reliant on technology, is also having to undergo swift change. This affects the training of surgeons and has implication for the continuous professional development of senior surgeons. In addition, the exponential advancement of technology referred to by some authors as “disruptive technology”1 and its incorporation into almost every aspect of life has meant that even the most ardent conservative will eventually have to cave into the pressure to conform.Enter the era of simulation, a novel concept that has been employed in numerous fields including that of defense, aviation and recently in surgery.2 Simulation seems to hold the answer to several of the challenges faced by the field of surgery, especially within surgical training. This paper will first address the concept of simulation and simulators, elucidate some of its applications in the field of surgery and then identify certain benefits and concerns associated with the use of simulators in surgical training. This will set the foundation to the objective of this essay, which is the utility of simulation as a tool in the domain of surgical education (i.e. for training and assessing trainee surgeons). Much of the literature has tended to focus on the design, validity and reliability of simulators, the development of curricula incorporating simulators, and criteria for being regarded as a competent surgeon, in a mutually exclusive manner. This essay will attempt to demonstrate that each of these aspects has an order of inter-relationship to one another. This proposed model of inter-relationship will enable us to gain new insights into how the links between them affect one another. The observation of
机译：模拟是一个已在许多领域中使用的概念，包括国防，航空和最近的外科领域。模拟似乎可以解决外科领域面临的一些挑战。在这项研究中，作者回顾了模拟器在外科手术中的使用历史，然后回顾了模拟器在外科手术中的各种应用。这将为这项研究的目标奠定基础，这是将模拟作为手术教育领域（即用于培训和评估实习医生的工具）的一种工具。许多文献倾向于以相互排斥的方式集中于模拟器的设计，有效性和可靠性，包含模拟器的课程的开发以及被视为有能力的外科医生的标准。 [ii]，[iii]，[iv]这项研究将试图证明这些方面中的每一个都有相互关联的顺序。提出的这种相互关系模型将使我们能够获得关于它们之间的链接如何相互影响的新见解。观察此命令将首先使模拟器更有效地用作培训未来外科医生的工具。其次，这将避免由于引入新技术而可能发生的质量控制崩溃，这方面的主要例子是腹腔镜胆囊切除术的惨败，在1990年代导致胆管损伤急剧增加。[v]最后，作者还将演示该模型中的持续反馈如何实现系统的连续微调。 Satava RM。手术模拟的历史回顾–个人观点。世界J外科杂志2008; 32：141-148。[ii] McClusky DA，Smith CD。外科技能模拟课程的设计和开发。世界J外科杂志2008; 32：171-181。[iii] Aucar JA，Nicholas RG，Troxel SA等人。关于手术模拟的综述，并关注验证方法。 Surg Laparosc endosc percutan tech 2005; 15（2）：82-89。[iv] Sarker SK，PatelB。模拟和外科手术训练。 Int J临床实践2007; 61（12）：2120-2125。[v] Wanzel KR，病房M，Reznick RK。教授外科手工艺：从选择到认证。 Curr Probl Surg 2002; 39：573-660。引言随着技术的飞速发展，越来越依赖技术的外科领域也必须进行迅速的变革。这影响了外科医生的培训，并且对高级外科医生的持续专业发展具有影响。此外，一些作者将技术的指数级发展称为“破坏性技术” 1，并将其纳入生活的几乎每个方面，这意味着即使是最热衷的保守派​​人士也最终将不得不屈服于顺应性的压力。模拟，这是一个已在国防，航空和最近的外科等众多领域中采用的新颖概念。2模拟似乎可以解决外科领域所面临的若干挑战，特别是在外科培训领域。本文将首先讨论模拟和模拟器的概念，阐明其在外科手术领域中的一些应用，然后确定与在手术训练中使用模拟器相关的某些好处和关注点。这将为本文的目标奠定基础，这是模拟在外科手术教育领域（即用于培训和评估实习医生的工具）中的实用性。许多文献倾向于以相互排斥的方式集中于模拟器的设计，有效性和可靠性，包含模拟器的课程的开发以及被视为有能力的外科医生的标准。本文将试图证明这些方面中的每一个都有相互关联的顺序。提出的这种相互关系模型将使我们能够获得关于它们之间的联系如何相互影响的新见解。的观察

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