Revista do Colégio Brasileiro de Cirurgiões
https://app.periodikos.com.br/journal/rcbc/article/doi/10.1590/0100-6991e-20260022
Revista do Colégio Brasileiro de Cirurgiões
Artigo Original

Validação de um simulador sintético de endoscopia da coluna lombar: transferência de habilidades para a cirurgia real

Validation of a synthetic lumbar spinal endoscopy simulator: skills transfer to real surgery

Álynson Larocca Kulcheski; Paul André Alain Milcent; Xavier Soler i Graells; João Gabriel Belegante Scalabrin; Carolline Popovicz Nunes; Edmar Stieven Filho

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Resumo

Introdução: Os simuladores cirúrgicos oferecem benefícios substanciais para o treinamento de habilidades técnicas, proporcionando um ambiente sem riscos para a prática. No entanto, o acesso a simuladores eficazes na educação cirúrgica ainda é limitado. Este estudo teve como objetivo validar um simulador sintético de endoscopia lombar por meio da transferência de habilidades e avaliar sua aplicabilidade educacional.

Métodos: Quarenta estudantes de medicina foram randomizados para treinamento no simulador (n=20) ou grupo controle (n=20). Após o treinamento, todos realizaram endoscopia diagnóstica supervisionada. Os procedimentos foram gravados e avaliados por um examinador cego quanto ao tempo total, desvios de olhar para baixo (look-downs), perda de instrumento, intervenções do supervisor e escore Global Operative Assessment of Laparoscopic Skills (GOALS). Um questionário em escala de Likert avaliou percepções sobre o treinamento em simulação.

Resultados: O grupo intervenção apresentou desempenho superior, com reduções de 43,7% no tempo de procedimento, 85,3% em look-downs, 75,9% em intervenções, 93,3% na duração da perda de instrumentos e 91,2% no percentual do tempo total em perda (p<0,001). Os escores GOALS foram significativamente maiores em todos os domínios (p<0,001). Todos os participantes apoiaram a incorporação da simulação na educação médica.

Conclusão: O simulador demonstrou forte validade de transferência, melhorando significativamente o desempenho cirúrgico. Os escores GOALS triplicaram entre os participantes treinados no simulador, e a aceitação para uso educacional foi unânime.

Palavras-chave

Educação de Graduação em Medicina; Endoscopia; Treinamento por Simulação; Coluna Vertebral; Estudantes de Medicina; Estudo de Validação

Abstract

Introduction: Surgical simulators offer substantial benefits for technical skills training by providing a risk-free environment for practice. However, access to effective simulators in surgical education remains limited. This study aimed to validate a synthetic lumbar spinal endoscopy simulator through skills transfer and assess its educational applicability.

Methods: Forty medical students were randomized to simulator training (n=20) or control (n=20). After training, all performed supervised diagnostic endoscopy. Procedures were recorded and evaluated by a blinded examiner for total time, look-downs, instrument loss, supervisor interventions, and Global Operative Assessment of Laparoscopic Skills (GOALS). A Likert-scale questionnaire assessed perceptions of simulation training.

Results: The intervention group showed superior performance, with reductions of 43.7% in procedure time, 85.3% in look-downs, 75.9% in interventions, 93.3% in instrument loss duration, and 91.2% in total loss percentage (p<0.001). GOALS scores were significantly higher in all domains (p<0.001). All participants endorsed incorporating simulation into medical education.

Conclusion: The simulator demonstrated strong transfer validity, significantly improving surgical performance. GOALS scores tripled among simulator-trained participants, and acceptance of the simulator for educational use was unanimous.

Keywords

Endoscopy; Medical Education; Medical Students; Simulation Training; Spine; Validation Study

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Submetido em:
13/11/2025

Aceito em:
09/12/2025

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