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首页> 外文期刊>Archives of otolaryngology--head & neck surgery. >Criterion-based (proficiency) training to improve surgical performance
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Criterion-based (proficiency) training to improve surgical performance

机译：基于标准的（熟练）培训，以提高手术表现

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Objective: To investigate whether training otorhinolaryngology residents to criterion performance levels (proficiency) on the Endoscopic Sinus Surgery Simulator produces individuals whose performance in the operating room is at least equal to those who are trained by performing a fixed number of surgical procedures. Design: Prospective cohort. Setting: Two academic medical centers in New YorkCity. Participants: Otorhinolaryngology junior residents composed of 8 experimental subjects and 6 control subjects and 6 attending surgeons. Intervention: Experimental subjects achieved benchmark proficiency criteria on the Endoscopic Sinus Surgery Simulator; control subjects repeated the surgical procedure twice. Main Outcome Measures: Residents completed validated objective tests to assess baseline abilities. All subjects were videotaped performing an initial standardized surgical procedure. Residents were videotaped performing a final surgery. Videotapes were assessed for metrics by an expert panel. Results: Attendings outperformed the residents in most parameters on the initial procedure. Experimental and attending groups outperformed controls in some parameters on the final procedure. There was no difference between resident groups in initial performance, but the experimental subjects outperformed the control subjects in navigation in the final procedure. Most important, there was no difference in final performance between subgroups of the experimental group on the basis of the number of trials needed to attain proficiency. Conclusions: Simulator training can improve resident technical skills so that each individual attains a proficiency level, despite the existence of an intrinsic range of abilities. This proficiency level translates to at least equal, if not superior, operative performance compared with that of current conventional trainingwith finite repetition of live surgical procedures.
机译：目的：研究是否在鼻内窥镜鼻窦手术模拟器上训练耳鼻喉科住院医师以达到标准的表现水平（熟练程度），从而产生其在手术室中的表现至少等于通过固定数量的外科手术训练的人。设计：预期队列。地点：纽约市的两个学术医学中心。参加者：耳鼻咽喉科初级住院医师，由8位实验对象，6位对照对象和6位主治医师组成。干预：实验对象在内窥镜鼻窦手术模拟器上达到基准熟练标准;对照对象重复两次手术程序。主要结果指标：居民完成了经过验证的客观测试，以评估基线能力。对所有受试者进行录像，以进行初始的标准化手术程序。对居民进行了最后一次手术的录像。录像带由专家小组进行评估。结果：在初始程序中，参加者的表现在大多数参数上均优于居民。在最终程序的某些参数上，实验组和参加组的表现优于对照组。居民组之间在初始表现上没有差异，但在最终程序中，实验对象在导航方面优于对照组。最重要的是，根据达到熟练程度所需的试验次数，实验组各亚组之间的最终表现没有差异。结论：模拟器培训可以提高居民的技术技能，从而使每个人都达到熟练水平，尽管存在内在的能力范围。与目前的有限重复活手术程序的常规培训相比，该熟练水平至少相当于或什至不是更好的手术性能。

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