摘要
对基于模拟技术的腹腔镜手术培训在腹腔镜手术技能获取过程中的作用进行柯式模型评估。采用范围综述法在多个数据库检索关于腹腔镜模拟器用于腹腔镜手术技能培训的文献并进行人工排除及阅读记录。根据柯氏四层级评估模型进行分类整合,评估腹腔镜模拟器培训的作用及特点,并分析文献对各层级培训成效的评估方法,以指导日后的课程设计及评估工作。基于模拟技术的腹腔镜手术培训效果主要集中在柯式评估模型的反应层、学习层和行为层,具体评估可通过问卷调查或评估访谈、对模拟器客观记录进行研究和编制评判标准、对完成培训后的相应临床操作表现进行评估。成果层评估目前尚缺少文献支持。应用基于模拟的腹腔镜手术培训,能够有效地在柯氏评估模型反应层、学习层和行为层对学员产生影响。研究并建立有效的腹腔镜技能培训课程和评估体系是确保学员通过模拟培训获取腹腔镜技术并向临床应用转移的关键。
This article aims to evaluate the effectiveness of simulation-based laparoscopic surgery training in laparoscopic surgical skills acquisition process by using Kirkpatrick model. From multiple leading databases, literatures of laparoscopic simulator training for laparoscopic surgical skills were retrieved and scoping-reviewed. The reported effectiveness and characteristics of laparoscopic simulator training were then synthesized and analyzed according to the criteria of Kirkpatrick's four levels of training. The evaluation methods used on the effectiveness of training at different Kirkpatrick levels were also investigated, in the hope of guiding future course design and evaluation. The results indicated that simulation-based laparoscopic surgery training was effective in Kirkpatrick's Reaction, Learning and Behavior Levels. Methods for effectiveness evaluations included questionnaire surveys or evaluation interviews, researches in objective simulator records and developing evaluation criteria, and follow-up evaluations of respective clinical operation performance. No data on the Kirkpatrick Results Level was found. When it came to laparoscopic surgical skills acquisition, simulation-based laparoscopic surgery training had effective impacts on trainees in Kirkpatrick's Reaction, Learning and Behavior levels. To study and establish effective training courses and evaluation systems for laparoscopy surgery training is the key to ensure that trainees can acquire laparoscopic surgical skills through training, and more importantly, they can apply those in the clinical practice.
引文
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