累积和 - 一个个性化的熟练程度指标用于腹腔镜的基本原则

累积和 - 一个个性化的熟练程度指标用于腹腔镜的基本原则
Cumulative sum- An individualized proficiency metric for laparoscopic fundamentals

Abstract
摘要
BACKGROUND:
背景：
A reliable metric of technical proficiency is indispensable to the training of fellows and residents. The purpose of this study was to determine whether cumulative sum (Cusum) has predictive validity in laparoscopic training. We hypothesized that Cusum would be a better predictor of technical ability in fundamentals of laparoscopic surgery (FLS) than traditional practice volume metrics.
一个可靠的技术水平的度量是必不可少的研究员和居民的培训。本研究的目的是确定是否累积和（CUSUM）在腹腔镜训练中的预测效度。我们推测，Cusum将是一个更好的预测在腹腔镜手术基本技能（FLS）比传统的实践量指标。

METHODS:
方法:
Twenty medical students were recruited to practice three FLS tasks: peg transfer, circle cut, and intracorporeal knot tie. Up to 7hours of self-directed practice was allotted to each participant. Practice attempts were scored by standard FLS criteria and monitored via Cusum. Each participant's terminal Cusum performance was analyzed retrospectively. Posttests were conducted by faculty blinded to practice performance.
招募了二十名医学生练习三个FLS的任务：PEG转移，圆切，和体内打结。到7小时自主实践被分配给每个参与者。实践尝试进行评分标准FLS标准和监测通过CUSUM。每个参与者的终端应用表现进行回顾性分析。测试后由教师盲目练习表演。

RESULTS:
结果:
Eighteen participants completed the study (90%). Median adjusted posttest scores were 102.3, 84.1, and 78.6 for peg transfer, circle cut, and knot tie, respectively. For the knot tie task, participants who exceeded the Cusum decision interval during their final practice attempts performed significantly higher on posttesting (81.2 vs 71.5, p=0.015). Knot tie terminal Cusum score was positively associated with posttest performance after adjusting for practice volume (p=0.031). Total practice volume and practice time were not significantly associated with posttest performance for any FLS task.
十八名学员完成了这项研究（90%）。调整后的平均得分分别为102.3、84.1、和78.6的PEG传输，圆切割，打结，分别。对于打结的任务，参与者超过CUSUM决策区间最终实践中尝试进行验后明显升高（81.2 vs 71.5，P = 0.015）。结终端CUSUM评分呈正调整后的实际量测性能相关（P = 0.031）。总的练习量和练习时间不在后测成绩有显著相关的任何FLS的任务。

CONCLUSION:
结论：
Cusum score is a more valid representation of FLS proficiency than practice volume or practice time. Incorporating Cusum in a clinical setting may promote more efficient allocation of time resources and operative volume.
CUSUM分数是一个更有效的表达水平比实际体积或FLS的练习时间。在临床上采用CUSUM可以促进时间资源和手术量更有效配置。

原文：
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Cumulative sum- An individualized proficiency metric for laparoscopic fundamentals