手术室护士掌握达芬奇机器人基础操作技能的学习曲线

A prospective study on the learning curve of basic operation skills of Leonardo da Vincirobot surgery system

目的探讨手术室护士掌握达芬奇机器人基础操作技能所需要的最少操作例数,为达芬奇机器人手术系统的手术配合护士的资格准入标准的制订和技能培训提供参考依据。方法以独立配合达芬奇机器人手术的护士为研究对象,记录其单只无菌器械臂罩装置时间、参数设置时间、人机对接次数和术后系统处理时间4个评价指标数据并计算累积和值,绘制个体学习曲线图,拟合得到总体学习曲线图。结果共有10名护士配合达芬奇机器人手术150例,个体学习曲线斜率开始降低的操作例数为3~14例,总体学习曲线斜率自第9例操作起开始降低。结论手术室护士掌握达芬奇机器人基础操作技能的学习曲线可以分为学习探索阶段和熟练掌握阶段,而达到熟练掌握阶段至少需累积9例手术经验。

Objective To explore the minimum operations needed by nurses in operating room to master the basic skills of Leonardo da Vincirobot surgery system,and to provide reference for the establishment of Leonardo da Vincirobot surgery system cooperation qualification admission standards and skill training.Methods Nurses who independently cooperated with Leonardo da Vincirobot surgery system operation were eligible for the study.Four evaluation indexes,including the arm cover device time,the parameter setting time,the man-machine docking times and the postoperative system processing time were recorded.The cumulative sum value was calculated to draw the individual learning curve,and the overall learning curve was obtained by fitting.Results Ten nurses assisted with a total of 150 operations.The slope of individual learning curve began to decrease in 3 to 14 cases.The overall learning curve began to decrease in case 9.Conclusion Through cumulative sum analysis,the learning curve of basic operation skills of Leonardo da Vincirobot surgery system can be divided into two stages:learning and exploration stage and proficiency stage,and at least 9 cases of surgical experience should be accumulated to reach proficiency stage.