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Development and evaluation of cesarean section surgical training using computer-enhanced visual learning

机译：利用计算机视觉学习技术进行剖宫产手术培训的开发和评估

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Background: Skilled performance of cesarean deliveries is essential in obstetrics and gynecology residency. A computer-enhanced visual learning module (CEVL Cesarean) was developed to teach cesarean deliveries.Methods: An online module presented cesarean deliveries as a series of components using text, audio, video and animation. First-year residents used CEVL Cesarean and were evaluated intra-operatively by trained raters, then provided feedback about surgical performance. Clinical outcomes were collected for approximately 50 cesarean deliveries for each resident.Results: From 2010 to 2011, 12 first-year residents participated in the study. About 406 unique observed cesarean deliveries were analyzed. Procedures up to each resident's 70th case were analyzed by grouping cases in 10s (cases 1-10 and 11-20), or deciles. Resident performance significantly improved by decile [χ2(6)=47.56, p0.001]. When examining each resident's performance, surgical skill acquisition plateaued by cases 21-30. Procedural performance, independent of resident, also improved significantly by decile [χ2(6)=186.95, p0.001], plateauing by decile 4 (cases 31-40). Throughout the observation period, operative time decreased by 3.84min (p=0.006).Conclusions: Pre-clinical teaching using computer-based modules for cesarean sections is feasible to develop. Novice surgeons required at least 30 procedures before performing the procedure competently. When residents performed competently, operative time and complications decreased.
机译：背景：剖宫产的熟练执行对妇产科住院医师至关重要。开发了一个计算机增强的视觉学习模块（CEVL Cesarean）来教授剖宫产的方法。方法：一个在线模块通过文本，音频，视频和动画的形式，将剖宫产演示为一系列组成部分。一年级居民使用CEVL剖腹产，并由训练有素的评估者进行术中评估，然后提供有关手术表现的反馈。收集了每个居民大约50例剖宫产的临床结果。结果：从2010年到2011年，有12名第一年住院医师参加了这项研究。分析了约406次观察到的剖宫产。对每个居民的第70个案例的处理程序通过将案例按10s（案例1-10和11-20）或decils分组进行分析。十分位数显着改善了居民的表现[χ2（6）= 47.56，p0.001]。在检查每位居民的表现时，手术技能的掌握受到案例21-30的影响。十分位数[χ2（6）= 186.95，p0.001]，十分位数4达到平稳水平（案例31-40），独立于居民的程序性能也显着提高。在整个观察期内，手术时间减少了3.84分钟（p = 0.006）。结论：使用基于计算机的剖宫产模块进行临床前教学是可行的。新手外科医生至少需要执行30个步骤才能熟练地执行该步骤。当居民表现出色时，手术时间和并发症减少。

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