Learning Curve of Microsurgical Anastomosis: Training for Resident Education.

IF 2.6 2区 医学 Q1 ORTHOPEDICS Journal of the American Academy of Orthopaedic Surgeons Pub Date : 2025-01-15 DOI:10.5435/JAAOS-D-24-00981
Dae Hee Lee, Young Kwang Shin, Su Hyeok Son, Kyung Wook Kim
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Abstract

Background: Acquiring microsurgical anastomosis skills requires considerable time and effort. Moreover, appropriate and systematic training for acquiring microsurgical anastomosis skills is lacking. Therefore, this study investigated the learning curve for acquiring microsurgical anastomosis techniques among orthopaedic surgery residents.

Methods: The study involved 12 orthopaedic surgery residents without experience in microsurgical anastomosis. The residents were divided into two groups: the 'Experienced group' with more than 6 months of suturing experience and the 'Inexperienced group' with no suturing experience. Each participant underwent 30 practice sessions, suturing a 3.5-mm diameter silastic tube. The time taken for each anastomosis and its quality were evaluated. Individual learning curves were derived, and the number of trials required to reach the time plateau was determined.

Results: The Experienced group reached the time plateau after an average of 16.3 ± 1.4 attempts while the Inexperienced group reached it after an average of 24.2 ± 2.5 attempts. The time required for the first two attempts was 40.4 ± 6.2 min for the Experienced group and 61.2 ± 8.6 min for the Inexperienced group (P < 0.001). The time required for the last two attempts was 11.4 ± 0.7 min for the Experienced group and 12.8 ± 0.8 min for the Inexperienced group. Comparing the quality scores of the first two attempts, the Experienced group scored 4.3 ± 0.5 points and the Inexperienced group scored 3.1 ± 0.5 points (P < 0.001). The Experienced group scored 7.8 ± 0.5 points for the last two attempts while the Inexperienced group scored 6.9 ± 0.3 points (P < 0.001).

Conclusions: Individuals new to suturing improved anastomosis time and quality by approximately 30 times. This finding suggests that practitioners can optimize their training while educators can refine the curriculum by predicting learning curves and providing timely feedback to enhance skill development.

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显微外科吻合的学习曲线:住院医师教育的培训。
背景:掌握显微外科吻合技术需要大量的时间和精力。此外,缺乏适当和系统的显微外科吻合技能培训。因此,本研究调查骨科住院医师掌握显微外科吻合技术的学习曲线。方法:对12例无显微外科吻合经验的骨科住院医师进行研究。住院医师分为两组:有6个月以上缝合经验的“有经验组”和没有缝合经验的“无经验组”。每位参与者进行30次练习,缝合直径3.5 mm的硅胶管。评价每次吻合所需时间及吻合质量。导出了个体学习曲线,并确定了达到时间平台所需的试验次数。结果:有经验组平均16.3±1.4次达到时间平台,无经验组平均24.2±2.5次达到时间平台。有经验组前两次尝试所需时间为40.4±6.2 min,无经验组为61.2±8.6 min (P < 0.001)。有经验组最后两次尝试所需时间为11.4±0.7 min,无经验组为12.8±0.8 min。比较前两次尝试的质量得分,有经验组为4.3±0.5分,无经验组为3.1±0.5分(P < 0.001)。有经验组前两次得分为7.8±0.5分,无经验组前两次得分为6.9±0.3分(P < 0.001)。结论:新术者的吻合时间和质量提高了约30倍。这一发现表明,从业者可以优化他们的培训,而教育者可以通过预测学习曲线和提供及时的反馈来改进课程,以提高技能发展。
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来源期刊
CiteScore
6.10
自引率
6.20%
发文量
529
审稿时长
4-8 weeks
期刊介绍: The Journal of the American Academy of Orthopaedic Surgeons was established in the fall of 1993 by the Academy in response to its membership’s demand for a clinical review journal. Two issues were published the first year, followed by six issues yearly from 1994 through 2004. In September 2005, JAAOS began publishing monthly issues. Each issue includes richly illustrated peer-reviewed articles focused on clinical diagnosis and management. Special features in each issue provide commentary on developments in pharmacotherapeutics, materials and techniques, and computer applications.
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