背景:完成培训后,执业外科医生依靠动手课程来扩大他们的手术设备并提高他们的手术技术。然而,这些课程在标准化的教学方法上有所不同。SAGES开发了成果和程序转移数据采集(ADOPT)程序,作为一种利用标准化教学技术进行纵向教学的方法,导师,和网络研讨会,以涵盖其他技术。这项研究考察了ADOPT课程之前和之后对所学技术的采用以及参与者的信心,该课程专注于扩展视野完全腹膜外(eTEP)疝修复。
方法:进行了以eTEP疝修补术为重点的实践课程,纳入人数上限为10名。3、6和12个月的课前和课后调查确定了学习程序的实施情况,案例体积,和对eTEP技能的信心。5点Likert量表(1=完全不自信至5=完全自信)评估了置信水平。使用描述性统计对调查答复进行了总结。
结果:在10名参与者中,10人(100%)完成了课前调查,和7(70%)完成了至少一项课程后调查。年龄中位数为48.5岁(36,56岁),实际年龄中位数为16岁(2,23岁),主要在社区环境中(70%)。课程结束后,50%的人进行了eTEP手术,100%报告在手术计划期间考虑了这种技术。参与者报告说,与课程前水平相比,课程后三个月对eTEP特定技能的信心更高。对于以下技能,信心发生了最大的变化:进入腹侧疝的肌肉后/腹膜外间隙,并识别何时侵犯了白线,p<0.05。
结论:这项研究表明,通过ADOPT格式可以实现学习技术的快速整合。此外,通过纵向指导和结构化的实践课程,ADOPT课程支持执业外科医生获得自主性和信心,即使在教授相对具有技术挑战性的程序时,比如eTEP。
After completion of training, practicing surgeons rely on hands-on courses to expand their procedure armamentarium and improve their surgical technique. However, such courses vary in standardized teaching methods. SAGES developed the Acquisition of Data for Outcomes and Procedure Transfer (
ADOPT) program as a method of longitudinal instruction utilizing standardized teaching techniques, mentorship, and webinars to cover additional techniques. This study examines the adoption of learned techniques and participant confidence before and after an
ADOPT course focused on extended-view totally extraperitoneal (eTEP) hernia repair.
A hands-on course focused on eTEP hernia repair was conducted with enrollment capped at 10 participants. Pre-course and post-course surveys at 3, 6, and 12 months determined implementation of the learned procedure, case volume, and confidence with eTEP skills. A 5-point Likert scale (1 = not confident at all to 5 = completely confident) assessed confidence levels. Survey responses were summarized using descriptive statistics.
Of the 10 participants, 10 (100%) completed the pre-course survey, and 7 (70%) completed at least one post-course survey. Median age was 48.5 years (36,56) with a median of 16 years (2,23) in practice, mostly in the community setting (70%). After the course, 50% had performed an eTEP procedure, and 100% reported considering this technique during surgical planning. Participants reported higher confidence in eTEP-specific skills at three months post-course from pre-course levels. The highest change in confidence was seen for the following skills: accessing the retromuscular/extraperitoneal space for ventral hernia and recognizing when the linea alba has been violated, p < 0.05.
This study shows that rapid incorporation of learned techniques can be achieved through the
ADOPT format. Furthermore, through longitudinal mentorship and a structured hands-on course, the
ADOPT course supports practicing surgeons to attain autonomy and confidence even when teaching a relatively technically challenging procedure, such as eTEP.