Évaluation préliminaire de l'impact d'un stage pilote d'initiation à la gestuelle chirurgicale sur l'acquisition des habiletés techniques de base par les internes de chirurgie de premier semestre

Abstract

Résumé -Contexte : L'apprentissage de l'habileté technique chirurgicale (HTC) dans le système français de formation en chirurgie repose essentiellement sur l'immersion en situation réelle et le compagnonnage. De nouvelles contraintes pèsent sur l'exercice de la chirurgie dans les centres hospitaliers universitaires et pourraient réduire l'efficience de ce mode unique de transmission de l'HTC. Objectif : Évaluer l'impact sur l'acquisition de gestes chirurgicaux élémentaires (suture, ligature) Abstract -Context: In the French surgical education system, technical skill acquirement in surgery is based on real situations immersion and apprenticeship. There are new constraints affecting the surgical practice in academic hospital centres and it could reduce the efficacy of this unique surgical technical skill (STS) teaching approaches. Objective: To evaluate the impact of an experimental training course based on the acquisition of basic surgical skills (suture, ligature) on inanimate models outside the operative room. This training course was done in addition to the usual real situations immersion and apprenticeship learning approaches. Method: During a standardized suture and ligature drill, which was proposed 3 months after the beginning of the first semester, we compared the performances (scores and time) of a group of residents exposed to the training course to those of a group of residents not exposed to the training course. Results: The mean score obtained was 23.9 (15-28) and 17.1 (2-24) in the exposed group and in the non-exposed group, respectively: p = 0.036. The score obtained from the test assessing knowledge of surgical equipment was also higher in the exposed group. The mean time to complete the suture drill had a favourable tendency in the exposed group. Conclusion: Our results suggest that there is a positive and measurable impact of a training course given at the beginning of residency in surgery on the early acquisition of basic surgical technical skills. This type of teaching based on simulation should be a valuable complement to the immersion/apprenticeship teaching approaches for STS knowledge transmission.