手術操作チェックリストを用いた白内障手術教育法による達成度と教育的効果

Degree of achievement and effect of education on cataract surgery training system using a check list

要約　目的：チェックリストによる超音波水晶体乳化吸引術（PEA）手術教育の達成度と教育的効果の報告。方法：対象は手術研修医師4名がPEAを行った120眼である。術式は教材に準じ，合併症の危険性がある場合は指導医師と交代した。術後指導医師がチェックリストを記入，点数化し，手術初期5眼と最新5眼を比較検討した。結果：3名の総点数，4名の項目別点数が有意に上昇した。術者交代は30眼，前囊切開時21眼（70％）と多く，初期10眼目までに26眼（87％）と集中していた。合併症は後囊破囊，チン小帯断裂各2眼（1.7％）であった。結論：本教育法はPEAの達成度とその効果を客観的に測るのに有用である。

Abstract.　Purpose：To report the degree of achievement and effect of education on phacoemulsification（PEA）training system with adjunct use of check list. Method：Four residents performed PEA on 120 eyes at a university hospital. Initially, they performed PEA in accordance to teaching materials. After surgery, the teaching staff reviewed the procedures recorded on video tape which were graded using a check list. Each resident was evaluated regarding the initial and the last five surgeries. Results：The total point improved in 3 residents. Points for each procedure improved in 4 residents. The residents had to be replaced by senior ophthalmologists during 30 surgeries. Replacement was most frequent during capsulorrhexis and was more frequent during the initial 10 surgeries. Intraoperative complications included rupture of posterior capsule and zonule in 2 eyes each. Conclusion：This training system is useful in evaluating the degree of achievement of PEA by residents-in-training.