Error-Based Teaching Approach Decreases Vessel Anastomosis Errors: A Pilot Study

Eric de Haas, Jill P Stone, W. de Haas, Christiaan H. Schrag
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Abstract

Abstract Background Microsurgical anastomosis of vessels is a challenging skill that surgical residents should practice on models before attempting in the clinical setting. These skills are often taught using synthetic materials, animal tissue, or live animal models. With increasing constraints on surgical resident's time, it is important to maximize efficiency of microsurgical training. The purpose of this study is to determine if teaching surgical residents about common vessel anastomosis errors decreases the total number of suture errors during a 4-day training course. Methods Plastic surgery residents (R1–R3) were randomly assigned to receive additional teaching focused on either common microsurgical errors or traditional microsurgical manuals. The residents then performed anastomosis on rat femoral arteries in which the total number of sutures and errors were recorded by staff microsurgeons who were blinded to the intervention. Results Residents who received teaching on common microsurgical errors performed a total of 73 sutures of which 12 were errors. The control group who studied using traditional microsurgical manuals performed a total of 125 sutures of which 38 were errors. There was a statistically significant decrease in the total number of suture errors (Fisher's exact test; p-value = 0.04) and in the number of partial depth bite errors (Fisher's exact test p-value = 0.03). Conclusion Teaching surgical residents about common vessel anastomosis errors decreased the total number of errors when compared with traditional education methods using microsurgery manuals. Partial depth bite errors were also decreased through error-based teaching.
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基于错误的教学方法减少血管吻合错误的初步研究
背景血管显微外科吻合是一项具有挑战性的技术,外科住院医师在尝试临床前应先在模型上进行练习。这些技能通常使用合成材料、动物组织或活体动物模型来教授。随着住院医师时间的日益紧张,如何提高显微外科培训的效率显得尤为重要。本研究的目的是确定在为期4天的培训课程中,向外科住院医师教授常见血管吻合错误是否可以减少缝合错误的总数。方法随机选取整形外科住院医师(R1-R3)进行显微外科常见错误或传统显微外科操作手册的额外教学。然后住院医师对大鼠股动脉进行吻合,缝合和错误的总数由对干预不知情的工作人员显微外科医生记录。结果接受显微外科常见错误教学的住院医师共进行缝合73次,其中错误缝合12次。对照组使用传统显微外科手术手册,共进行125次缝合,其中38次错误。缝合错误总数有统计学意义的减少(Fisher精确检验;p值= 0.04),部分深度咬合错误数(Fisher精确检验p值= 0.03)。结论对外科住院医师进行血管吻合常见错误的教学,与传统的显微手术手册教学方法相比,减少了错误总数。通过错误教学,局部深度咬合错误也有所减少。
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发文量
6
审稿时长
14 weeks
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