Catherine T. Byrd MD , Winston L. Trope BE , H. Henry Guo MD, PhD , Kyle Gifford BA , Prasha Bhandari MPH , Jalen Benson AB , Douglas Z. Liou MD , Leah M. Backhus MD, MPH , Mark F. Berry MD , Joseph B. Shrager MD , Natalie S. Lui MD, MAS
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摘要

背景纵隔镜检查仍然是肺癌分期的重要组成部分。支气管内超声检查的发展意味着住院医师进行纵隔镜检查的次数减少。我们假设纵隔的三维打印模型将成为向住院医师传授纵隔镜检查解剖和技术的有效工具。在两年的时间里,住院医师和主治医师被要求在每次纵隔镜检查后提供技能评估。第二年,所有住院医师都接受了使用三维模型进行纵隔镜检查的标准化指导。结果共有 49 名住院医师和 65 名主治医师完成了问卷调查。与未使用三维模型教学的住院医师相比,使用三维模型教学的住院医师更有可能回答他们能 "很好"/"非常好 "地识别正常解剖结构(86% vs 52%,P = .015)。与未使用三维模型的住院医师相比,使用三维模型教学的住院医师更常回答他们能够 "很好"/"非常好 "地完成无并发症纵隔镜检查(59% vs 31%,P = .079),但这一比例并不显著。与未使用三维模型教学的住院医师相比,主治医师同样可能回答 "好"/"非常好 "使用三维模型教学的住院医师能够识别正常解剖结构(52% vs 55%,P = .99)和进行无并发症纵隔镜检查(48% vs 43%,P = .79)。
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Three-Dimensional Printed Model of the Mediastinum for Cardiothoracic Surgery Resident Education

Background

Mediastinoscopy remains an important component of lung cancer staging. The development of endobronchial ultrasonography has meant residents perform fewer mediastinoscopies. We hypothesized that a 3-dimensional printed model of the mediastinum would be an effective tool for teaching residents the anatomy and techniques for mediastinoscopy.

Methods

A color model of the mediastinum was 3-dimensionally printed based on segmented computed tomographic images. For 2 years, residents and attendings were asked to provide a skills assessment after every mediastinoscopy. During the second year, all residents received standardized instruction for mediastinoscopy using the 3-dimensional model. Skills assessments were compared between the residents taught with and without the 3-dimensional model.

Results

There were 49 resident and 65 attending surveys completed. Residents taught with the 3-dimensional model were more likely to answer that they could identify normal anatomy “well”/“very well” compared with residents taught without the model (86% vs 52%, P = .015). Residents taught with the 3-dimensional model more frequently answered they were able to perform an uncomplicated mediastinoscopy “well”/ “very well” (59% vs 31%, P = .079) compared with residents taught without the 3-dimensional model, although this was not significant. Attendings were equally likely to answer “well”/“very well” that residents taught with the 3-dimensional model could identify normal anatomy (52% vs 55%, P > .99) and perform an uncomplicated mediastinoscopy (48% vs 43%, P = .79) compared with those taught without the model.

Conclusions

A 3-dimensional printed model of the mediastinum may be an effective tool for teaching mediastinoscopy.
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