CUSUM学习曲线:它们可以和不能告诉我们什么
Peng-Lin Lin1, Feibi Zheng2, Minkyung Shin2
1Intuitive Surgical, 1020 Kifer Road, Sunnyvale, CA, 94086-5304, USA. Penglin.Lin@intusurg.com.
Surgical endoscopy
|July 17, 2023
概括
机器人辅助手术 (RAS) 手术时间的累积总和 (CUSUM) 曲线受外科医生病例获取率和分析病例的数量的影响. CUSUM曲线的峰值并不可靠地表明外科手术的熟练程度.
科学领域:
- 外科教育和培训外科教育和培训
- 机器人辅助外科手术 (RAS) 是一种
- 学习曲线评估学习曲线评估
背景情况:
- 在外科教育中,评估外科医生的新技能学习曲线至关重要.
- 运行时间的累积总和 (CUSUM) 曲线经常使用,但有局限性.
- 了解影响CUSUM曲线解释的因素对于准确的学习曲线评估至关重要.
研究的目的:
- 为了证明CUSUM方法在外科手术学习曲线评估中的局限性.
- 评估不同外科医生病例获取率的机器人辅助手术 (RAS) 中控制台时间的CUSUM.
- 评估改变总病例数对CUSUM曲线解释的影响.
主要方法:
- 比较CUSUM曲线的平均控制台时间外科医生完成他们的第一个20个RAS病例在13,26,39,或52周.
- 分析了前50个和100个案例的CUSUM.
- 包括前列腺切除,恶性子宫切除和 inguinal 的手术与大型外科医生队伍.
主要成果:
- 初始病例获取速度较快的外科医生 (13周内20例) 显示CUSUM曲线的斜率较低.
- 在扩展分析时,CUSUM曲线峰值的病例数从50例增加到100例.
- 更快的学习速度与学习曲线期间操作时间的变化较小相关.
结论:
- 具有较快初始机器人辅助手术 (RAS) 病例获取速度的外科医生表现出较少的手术时间变化.
- 预计CUSUM曲线的峰值受分析病例总数的影响,引入偏差.
- 单独的CUSUM曲线峰值不足以可靠地定义外科手术能力或"征服学习曲线".
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