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日本の心臓血管外科専門医制度において,2017年からシミュレーショントレーニングが必修化された.短期間に効率的に手術スキルを向上させる研修システムの一助としてのトレーニング機器について概説する.
Dr. William Halsted started residency-based surgical training at Johns Hopkins University in 1889. On the job training (OnJT) conducted there is an in-hospital training that residents imitate what senior doctors are doing with their patients. [See one, do one, teach one] is the word briefly expressing this traditional training. Since then all surgeons learned surgery from the mentors and senior doctors in this way. In this OnJT, surgeons spent many years and years and accumulated experience and tried to crime up step by step from beginners to experts. Off-the-job training (OffJT) is, in other words, “planned experience”. In OffJT, surgeons can experience every kind of skill by simulation. They can experience rare but critical situations, repeat the procedures while experiencing failures many times in trial and error fashion without putting any risk to the patient. In this report, currently available simulators and when and how to utilize them are introduced. Dry lab or synthetic model, wet lab or animal tissue/organ, live animal, cadaver and virtual simulation are presented and discussed.
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