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Các phương pháp đào tạo mô phỏng trong phẫu thuật aneurysm nội sọ—một đánh giá hệ thống
Tóm tắt
Với sự gia tăng độ phức tạp và giảm bớt môi trường tiếp xúc với phẫu thuật aneurysm nội sọ, việc đào tạo và duy trì kỹ năng phẫu thuật đã trở nên thách thức. Bài đánh giá này mở rộng về đào tạo mô phỏng cho kỹ thuật kẹp aneurysm nội sọ. Một đánh giá hệ thống đã được thực hiện theo các hướng dẫn PRISMA để xác định các nghiên cứu về đào tạo kẹp aneurysm sử dụng mô hình và mô phỏng. Kết quả chính là xác định các chế độ chủ yếu của quy trình mô phỏng, mô hình và phương pháp đào tạo liên quan đến đường cong học tập trong vi phẫu thuật. Các kết quả thứ cấp bao gồm đánh giá tính hợp lệ của các mô phỏng này và khả năng học hỏi từ việc sử dụng các mô phỏng đó. Trong số 2068 bài báo được sàng lọc, 26 nghiên cứu đáp ứng tiêu chí bao gồm. Các báo cáo được chọn đã sử dụng nhiều phương pháp mô phỏng khác nhau bao gồm các phương pháp ex vivo (n = 6); nền tảng thực tế ảo (VR) (n = 11); và các mô hình aneurysm tĩnh (n = 6) và động (n = 3) in 3D (n = 6). Các phương pháp đào tạo ex vivo có sự sẵn có hạn chế, các mô phỏng VR thiếu cảm giác và xúc giác, trong khi các mô hình tĩnh 3D thiếu các thành phần vi giải phẫu quan trọng và sự mô phỏng của dòng máu. Các mô hình 3D động bao gồm lưu lượng mạch đập có thể tái sử dụng và tiết kiệm chi phí nhưng thiếu các thành phần vi giải phẫu. Các phương pháp đào tạo hiện có là không đồng nhất và không mô phỏng một cách thực tế quy trình vi phẫu thuật hoàn chỉnh. Các mô phỏng hiện tại thiếu một số đặc điểm giải phẫu và các bước phẫu thuật quan trọng. Nghiên cứu trong tương lai nên tập trung vào việc phát triển và xác nhận một nền tảng đào tạo có thể tái sử dụng và tiết kiệm chi phí. Hiện tại không tồn tại phương pháp xác nhận hệ thống cho các mô hình đào tạo khác nhau, vì vậy cần xây dựng các công cụ đánh giá đồng nhất và xác nhận vai trò của mô phỏng trong giáo dục cũng như sự an toàn của bệnh nhân.
Từ khóa
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