中级训练课程.ppt

Ethical questions may be raised regarding the appropriate intervention of the assessing senior surgeon, should the trainee be performing badly or there be an unexpected operative complication. Other methods of surgical training which do not put patients directly at risk are becoming increasingly prominentis Low fidelity models are cheaper and are useful in practising simple surgical techniques. High fidelity models are more expensive and some models replicate a complete operation The main advantages of them are a safe environment, real time performance, record and playback, repetition and practice, immersive電腦顯示或系統）沉浸式的，呈三維虛擬實境 environment, objective measures of performance, impartiality, instant feedback and results. Moreover with costs coming down and computers being more powerful, simulators are becoming more affordable for institutions to buy. Simulators in use, for example, are for endoscopy (upper gastro-intestinal, colonoscopy, bronchoscopy, etc.) and laparoscopy (arthroscopy, cholecystectomy, suturing, etc.). Any system should undergo extensive validation (5) before they are used in training and assessment, as they can be shown to be inappropriate (6). Surgical simulation is a mode of training which is promising and may be effective. Technical errors in the simulated environment do not have clinical consequences and does not have a morbidity or mortality. However we must ensure that the competent skills learnt in the simulation environment are translated to the real environment. This can be achieved if the same assessment tools are used in both environments. 虛擬實境 * This allows the trainee to manipulate the images and obtain objective feedback on his performance from the computer. The computer programme can simulate physiological and physical responses such as bleeding, as a reaction to a procedure. These simulators allow the production of a realistic clinical environment where team-working is reinforced, bridging gaps in the operating theatre. ‘‘Dry’’ labs