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首页> 外文期刊>Surgical Endoscopy >Self-directed training with e-learning using the first-person perspective for laparoscopic suturing and knot tying: a randomised controlled trial Learning from the surgeon's real perspective
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Self-directed training with e-learning using the first-person perspective for laparoscopic suturing and knot tying: a randomised controlled trial Learning from the surgeon's real perspective

机译：利用第一人称视角下的电子学习自我导向培训，用于腹腔镜缝合和结捆绑：从外科医生的真正观点来看，随机对照试验学习

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Background Laparoscopic suturing and knot tying is essential for advanced laparoscopic procedures and requires training outside of the operating room. However, personal instruction by experienced surgeons is limitedly available. To address this, the concept of combining e-learning with practical training has become of interest. This study aims to investigate the influence of the first-person perspective in instructional videos, as well as the feasibility of a completely self-directed training curriculum for laparoscopic suturing and knot tying. Materials and methods Ninety-one laparoscopically naive medical students were randomised into two groups training with e-learning videos in either the first-person perspective (combining endoscopic view and view of hands/instruments/forearm motion) or the endoscopic view only. Both groups trained laparoscopic suturing and knot tying in teams of two until reaching predefined proficiency levels. Blinded, trained raters regularly assessed the participants' performance by using validated checklists. After training, participants filled out questionnaires regarding training experience and personal characteristics. Results Average training time to reach proficiency did not differ between groups [first-person perspective (min): 112 +/- 44; endoscopic view only (min): 109 +/- 47; p = 0.746]. However, participants from both groups perceived the first-person perspective as useful for learning new laparoscopic skills. Both groups showed similar baseline performances and improved significantly after training [Objective Structured Assessment of Technical Skills (OSATS) (max. 37 points): first-person perspective: 30.3 +/- 2.3; endoscopic view only: 30.8 +/- 2.3]. All participants managed to reach proficiency, needing 8-43 attempts without differences between groups. Visuospatial abilities (mental rotation) seemed to enhance the learning curve. Conclusion Modifying instructional videos to the first-person perspective did not translate into a better performance in this setting but was welcomed by participants. Completely self-directed training with the use of e-learning can be a feasible training approach to achieve technical proficiency in laparoscopic suturing and knot tying in a training setting.
机译：背景技术腹腔镜缝合和结捆绑对于先进的腹腔镜程序至关重要，并且需要在手术室外面的训练。但是，经验丰富的外科医生的个人教学是有利的。为了解决这个问题，将电子学习与实际培训相结合的概念已成为兴趣。本研究旨在调查第一人称视角在教学视频中的影响，以及腹腔镜缝合和结捆绑的完全自我导向培训课程的可行性。在第一人称视角（结合手/仪器/前臂运动的内窥镜视图和视图中，仅在第一人称视角或同组内窥镜视图和观察）或内窥镜视图中，材料和方法将九十一位腹腔镜上幼稚的医学学生随机分为两组培训。这两个团体训练腹腔镜缝合和结在两支球队中捆绑，直到达到预定义的熟练程度。盲目的训练有素的评估者通过使用经过验证的清单定期评估参与者的表现。培训后，参与者填写了关于培训经验和个人特征的问卷。结果达到熟练程度的平均培训时间在[第一人称视角（分钟）：112 +/-44;仅限内窥镜视图（分钟）：109 +/- 47; p = 0.746]。然而，两个团体的参与者认为第一人称视角是学习新的腹腔镜技能的有用。两组在培训后两组表现出类似的基线性能，并在培训后显着改善[客观结构化技能（Osats）（最大37分）：第一人称视角：30.3 +/- 2.3;仅限内窥镜视图：30.8 +/- 2.3]。所有参与者都设法达到熟练程度，需要8-43次尝试，没有群体之间的差异。探测能力（精神旋转）似乎增强了学习曲线。结论修改教学视频到第一人称的视角并未在此设置中转化为更好的性能，但受到参与者的欢迎。通过使用电子学习完全自我导向的培训可以是实现训练环境中腹腔镜缝合和结的技术熟练的可行训练方法。

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