Uso de modelo experimental de anastomose látero - lateral microcirúrgica no ensino de habilidades cirúrgicas na graduação

Abstract

Introdução: A anastomose arteriovenosa latero-lateral é um procedimento complexo para acadêmicos de medicina, pois requer treinamento repetitivo. Objetivo: Comparar o aprendizado de alunos do quinto e décimo semestres da graduação de medicina, após treinamento de anastomose arteriovenosa latero-lateral, em modelo para treinamento que utiliza línguas bovinas. Materiais e Métodos: Estudo realizado na Universidade Nove de Julho, São Paulo, SP, Brasil, com a participação de 20 graduandos de medicina (dois grupos de dez alunos, de quinto e décimo semestres). No primeiro dia os alunos assistiram aula sobre a técnica da anastomose arteriovenosa latero-lateral e realizaram o procedimento, sendo avaliados dez critérios quanto à realização do procedimento. Os grupos treinaram durante quatro sessões de duas horas e foram novamente submetidos à mesma avaliação. As notas médias foram analisadas pelo teste T de Student. Resultados: O grupo de quinto semestre obteve média de 3 pontos na avaliação 1 e 5 pontos na avaliação 2 (p = 0,08393). O grupo de décimo semestre obteve média de 5 pontos na avaliação 1 e 7 pontos na avaliação 2 (p = 0,08393). Conclusões: Comparando o desempenho dos alunos de quinto e décimo semestre, após treinamento específico da anastomose vascular proposta, houve melhora na nota dos dois grupos, mas não houve significância estatística quando os valores foram comparados.

Aperfeiçoando um modelo de treinamento para técnicas cirúrgicas vasculares

“…This is because its primary objective is reestablishment of blood flow to organs and tissues, which is a procedure that is necessary in many different specialties in addition to vascular surgery itself, including trauma surgery, organ transplantation, and construction of patches and reimplantation in plastic surgery. [1][2][3][4] Currently, the majority of general surgery residents' training is conducted on human beings, with demonstrations by more experienced surgeons. 1,5 However, construction of vascular anastomoses requires significant exposure, dissection, and temporary occlusion of the vessel, increasing the risk of complications, particularly when performed by an inexperienced surgeon.…”

“…6 The best way to acquire and develop this skill is through training with experimental models. 4 Simulators are inanimate models developed for training a specific technical or motor skill; and simulations are the various different situations in which use of this technical skill is part of the competence being trained. 2 Simulations are important in medical education because they enable a range of different skills to be trained, improving patient safety.…”

“…5,7 Another objective of simulation is to develop simpler and more functional training methods, using the lowest possible number of animals for experimentation, thereby adhering to the 3 Rs policy (refinement, replacement, and reduction). 4 This is why the American College of Surgeons considers use of skills training models and simulators for accreditation of specialists rather than animal models. 8 Among the training models most widely used today, "bench models" are of particular interest because they employ inanimate materials -whether artificial (rubber or foam structures) or biological (bovine tongue and other animal viscera) -that are low cost, but enable the basic principles of surgery to be taught.…”

“…8 Among the training models most widely used today, "bench models" are of particular interest because they employ inanimate materials -whether artificial (rubber or foam structures) or biological (bovine tongue and other animal viscera) -that are low cost, but enable the basic principles of surgery to be taught. 3,4 There are many different biological models for practicing vascular anastomoses, mostly involving animal viscera. [4][5][6][7] The current initiative within the scientific community is to diversify use of already-existing teaching models to continue the trend to reduce use of animals, in addition to reducing risks and optimize surgery time in humans.…”

“…3,4 There are many different biological models for practicing vascular anastomoses, mostly involving animal viscera. [4][5][6][7] The current initiative within the scientific community is to diversify use of already-existing teaching models to continue the trend to reduce use of animals, in addition to reducing risks and optimize surgery time in humans. 4,5…”