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首页> 外文期刊>Surgical Endoscopy >The laparoscopic performance of novice surgical trainees: testing for acquisition, loss, and reacquisition of psychomotor skills.
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The laparoscopic performance of novice surgical trainees: testing for acquisition, loss, and reacquisition of psychomotor skills.

机译：外科手术新手的腹腔镜表现：测试精神运动技能的获得，丧失和重新获得。

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BACKGROUND: It has been suggested that virtual reality (VR) might be useful for the selection of surgical trainees and the measurement of technical performance during preoperative training and retraining. This study was designed to determine whether it is possible to define and measure the acquisition, loss, and reacquisition of psychomotor skills in novice surgical trainees. METHODS: Novice surgical trainees (NSTs n = 10, junior surgical registrars with little or no prior experience with laparoscopic surgery) were tested and retested after 1 month using the Minimally Invasive Surgical Trainer-Virtual Reality. Two tasks were used: the simple task [stretch diathermy (SD)] and the more complex task [manipulation diathermy (MD)]. The score was derived from the time taken to complete the task and the number of errors that occurred. Acquisition is the difference between the first and last score of the first training session, loss is the difference in score that occurs between the last score of the first training session and the first score of the second training session, and reacquisition is the difference in the first and last scores of the second training session. A performance criterion level was defined for each task by testing a group of experienced laparoscopic surgeons (n = 10). Groups were compared using the nonparametric Wilcoxon signed rank test, with p < 0.05 considered to be significant. RESULTS: Acquisition of skill was found for five of 10 NSTs with the SD task and 10/10 for the MD task. As a group the NSTs achieved the criterion level from the outset with the SD task and exceeded it by the eighth attempt for the MD task. The best score was achieved with fewer attempts during the second training session for the SD but not the MD task. The defined parameters are expressed as mean percentage score +/- SD for the 10 NSTs and for each task. There was a 36% (+/- 26) acquisition for the SD task compared with 50% (+/- 4) for the MD task (Wilcoxon p = 0.241). There was a 23% (+/- 19) loss for the SD task compared with 81% (+/- 16) for the MD task (p < 0.005). There was a 20% (+/- 10) reacquisition for the SD task compared with 54% (+/- 7) for the MD task (p < 0.005). The mean scores were greater for the more complex task (MD), which was more useful in discriminating between the individual trainees and the two training sessions. CONCLUSIONS: It is possible to use VR to define the acquisition, loss, and reacquisition of psychomotor skills in individual NSTs and to compare them with a predefined performance criterion level. This study defines parameters that will be useful in repeated training sessions of NSTs in the preoperative phase of training and during retraining.
机译：背景：有人提出虚拟现实（VR）可能对外科手术学员的选择以及术前培训和再培训期间技术性能的测量很有用。这项研究旨在确定是否有可能定义和衡量新手外科手术学员中心理运动技能的获得，丧失和重新获得。方法：新手外科手术学员（NSTs n = 10，初级手术登记员，很少或没有腹腔镜手术经验）在1个月后使用微创外科手术教练虚拟现实进行了测试和重新测试。使用了两个任务：简单任务[舒展透热（SD）]和更复杂的任务[操纵透热（MD）]。分数来自完成任务所花费的时间和发生的错误数。习得是第一次训练的第一和最后分数之间的差，损失是第一次训练的最后分数和第二训练的第一分数之间发生的分数差，重新获得是第二训练的最后分数之间的差。第二次训练的第一和最后的分数。通过测试一组经验丰富的腹腔镜外科医生（n = 10），为每个任务定义了绩效标准。使用非参数Wilcoxon符号秩和检验对各组进行比较，p <0.05被认为是显着的。结果：发现10个NST中有5个具有SD任务，而10/9具有MD任务，掌握了技能。作为一个整体，NST从一开始就通过SD任务达到了标准水平，并且在进行MD任务的第八次尝试中超过了标准水平。在第二次SD训练中，尝试次数较少的尝试获得了最佳成绩，但MD任务却没有。定义的参数表示为10个NST和每个任务的平均百分比分数+/- SD。 SD任务的采集率为36％（+/- 26），而MD任务的采集率为50％（+/- 4）（Wilcoxon p = 0.241）。 SD任务损失23％（+/- 19），而MD任务损失81％（+/- 16）（p <0.005）。 SD任务的重新获得率为20％（+/- 10），而MD任务的重新获得率为54％（+/- 7）（p <0.005）。较复杂的任务（MD）的平均得分更高，这在区分单个受训者和两个培训课程时更有用。结论：有可能使用VR来定义各个NST中心理运动技能的获得，丧失和重新获得，并将其与预定的绩效标准水平进行比较。这项研究定义了参数，这些参数将在培训的术前阶段和再培训期间的NST重复培训中有用。

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