目的:使用模拟器量化耳鼻咽喉科住院医师耳内镜技能获取的学习曲线。次要目标是确定人口统计学因素或先前的内窥镜检查经验是否会影响技能发展。
方法:前瞻性,多中心研究。每个居民参与者使用经过验证的内窥镜耳技能训练器完成了10项累积试验。
方法:两所学术教学医院。
方法:耳鼻咽喉科住院医师。
方法:试验完成时间;随时间的改善率。
结果:38名居民完成了研究,方案A有26名,方案B有12名。15名参与者是女性,23名是男性。平均年龄为30岁(范围26至34岁)。耳内窥镜检查(B=-16.7,p=0.005)和鼻窦内窥镜检查(B=-23.4,p=0.001)的先前经验与较低的总体试验时间独立相关。年龄,性别,研究生年,用手,对耳科的兴趣,视频游戏与试验时间无关.在多元逻辑回归中,居民完成时间随着试用次数的增加而增加,没有内窥镜检查经验的居民比有经验的居民的改善速度更快(p<0.001)。
结论:新手外科医生可以通过自我指导的模拟训练获得基本的内窥镜耳镜经验。经耳道内窥镜耳手术的学习曲线与其他耳科手术的学习曲线相当,具体任务能力可以在10次试验中实现,暗示以前的经历,或缺乏,可能不会决定获得新技能的能力。在学习经道内窥镜耳手术时,可能对以前的内窥镜鼻窦经验有转化价值。
Quantify the learning curve for endoscopic ear skills acquisition in otolaryngology residents using a simulator. The secondary objective was to determine if demographic factors or previous endoscopic experience influenced skill development.
Prospective, multicenter
study. Resident participants each completed 10 amassed trials using a validated endoscopic ear skill trainer.
Two academic teaching hospitals.
Otolaryngology residents.
Trial completion times; rate of improvement over time.
Thirty-eight residents completed the
study, 26 from program A and 12 from program B. Fifteen participants were women and 23 were men. Mean age was 30 years old (range 26 to 34 years). Previous experience with otoendoscopy (B = -16.7, p = 0.005) and sinus endoscopy (B = -23.4, p = 0.001) independently correlated with lower overall
trial times. Age, gender, postgraduate year, handedness, interest in otology, and video gaming were not associated with trial times. On multivariate logistic regression, resident completion times improved with
trial number, and residents without previous endoscopy experience improved at a faster rate than those with experience ( p < 0.001).
Novice surgeons may acquire basic endoscopic ear experience with self-directed simulation training. The learning curve for transcanal endoscopic ear surgery is comparable to those demonstrated for other otologic surgeries, and specific task competencies can be achieved within 10 trials, suggesting that previous experiences, or lack thereof, may not dictate the ability to acquire new skills. There may be a translational value to previous endoscopic sinus experience on learning transcanal endoscopic ear surgery.