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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">neurosurgery</journal-id><journal-title-group><journal-title xml:lang="ru">Нейрохирургия</journal-title><trans-title-group xml:lang="en"><trans-title>Russian journal of neurosurgery</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1683-3295</issn><issn pub-type="epub">2587-7569</issn><publisher><publisher-name>Издательский дом "МедИНК"</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.63769/1683-3295-2017-0-2-66-71</article-id><article-id custom-type="elpub" pub-id-type="custom">neurosurgery-405</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБУЧЕНИЕ В НЕЙРОХИРУРГИИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>EDUCATION IN NEUROSURGERY</subject></subj-group></article-categories><title-group><article-title>Практическая подготовка нейрохирургов в России. Часть 2. Опыт и перспективы</article-title><trans-title-group xml:lang="en"><trans-title>The practical training of neurosurgeons in Russian Federation. Part 2. Experience and perspectives</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Крылов</surname><given-names>Владимир Викторович</given-names></name><name name-style="western" xml:lang="en"><surname>Krylov</surname><given-names>V. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Левченко</surname><given-names>Олег Валерьевич</given-names></name><name name-style="western" xml:lang="en"><surname>Levchenko</surname><given-names>O. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Закондырин</surname><given-names>Дмитрий Евгеньевич</given-names></name><name name-style="western" xml:lang="en"><surname>Zakondyrin</surname><given-names>D. E.</given-names></name></name-alternatives><email xlink:type="simple">russiandoctor@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff xml:lang="ru" id="aff-1"><institution>МГМСУ им. А.И. Евдокимова; НИИ скорой помощи им. Н.В. Склифосовского</institution><country>Russian Federation</country></aff><aff xml:lang="ru" id="aff-2"><institution>НИИ скорой помощи им. Н.В. Склифосовского</institution><country>Russian Federation</country></aff><pub-date pub-type="collection"><year>2017</year></pub-date><pub-date pub-type="epub"><day>24</day><month>11</month><year>2017</year></pub-date><volume>0</volume><issue>2</issue><fpage>66</fpage><lpage>71</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Крылов В.В., Левченко О.В., Закондырин Д.Е., 2017</copyright-statement><copyright-year>2017</copyright-year><copyright-holder xml:lang="ru">Крылов В.В., Левченко О.В., Закондырин Д.Е.</copyright-holder><copyright-holder xml:lang="en">Krylov V.V., Levchenko O.V., Zakondyrin D.E.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.therjn.com/jour/article/view/405">https://www.therjn.com/jour/article/view/405</self-uri><abstract><p>Цель. Определение задач симуляционной подготовки, критериев и механизма аттестации практических навыков нейрохирургов стали темой данной статьи. Методы. Результатом поиска в базе данных PubMed стали 19 зарубежных публикаций, посвященных вопросам симуляционного образования и кривой обучения в нейрохирургии. Проведен анализ действующего российского законодательства, касающегося вопросов практической аккредитации врачей. Результаты. На основании анализа литературы сделаны предложения по разделению нейрохирургических вмешательств по уровню сложности и практикующих врачей по уровню компетентности. Выдвинута концепция организации практической аккредитации нейрохирургов в рамках системы непрерывного медицинского образования Заключение. Необходима организация системы практической подготовки и аккредитации нейрохирургов на базе симуляционно-аккредитационных центров.</p></abstract><trans-abstract xml:lang="en"><p>Objective. To define the tasks of simulation training as well as the criteria and mechanisms for practical skills certification of neurosurgeons. Methods. The search in the database PubMed data revealed 19 foreign publications devoted to issues of education and training of a simulation curve in neurosurgery. The analysis of the Russian legislation concerning issues of practical accreditation of doctors was performed. Results. The suggestions for dividing the neurosurgical interventions on the terms of complexity and practitioners on the levels of competence were made based on the literature data analysis. The concept of the practical organization of accreditation neurosurgeons within continuing medical education was initiated Conclusions. It is necessary to organize the system of practical training and accreditation of neurosurgeons at the base of simulation-accreditation centers.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>нейрохирургия</kwd><kwd>симуляционное обучение</kwd><kwd>практическая аккредитация</kwd><kwd>simulative education</kwd><kwd>neurosurgery</kwd><kwd>accreditation</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Федеральный Закон № 323от 21.11.11«Об основах охраны здоровья граждан в Российской Федерации»</mixed-citation><mixed-citation xml:lang="en">Федеральный Закон № 323от 21.11.11«Об основах охраны здоровья граждан в Российской Федерации»</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Приказ Минздравсоцразвития РФ № 1475н от 05.12.2011 «Об утверждении федеральных государственных требований к структуре основной профессиональной образовательной программы послевузовского профессионального образования (ординатура)»</mixed-citation><mixed-citation xml:lang="en">Приказ Минздравсоцразвития РФ № 1475н от 05.12.2011 «Об утверждении федеральных государственных требований к структуре основной профессиональной образовательной программы послевузовского профессионального образования (ординатура)»</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Приказ Минздравсоцразвития РФ № 585н от 22.08.2013 «Об утверждении Порядка участия обучающихся по основным профессиональным образовательным программам и дополнительным профессиональным образовательным программам в оказании медицинской помощи гражданам и в фармацевтической деятельности»</mixed-citation><mixed-citation xml:lang="en">Приказ Минздравсоцразвития РФ № 585н от 22.08.2013 «Об утверждении Порядка участия обучающихся по основным профессиональным образовательным программам и дополнительным профессиональным образовательным программам в оказании медицинской помощи гражданам и в фармацевтической деятельности»</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Письмо Минздравсоцразвития РФ от 18.04.2012. № 16-2/10/2-3902«О порядке организации и проведения практической подготовки по основным образовательным программам среднего, высшего и послевузовского медицинского или фармацевтического образования и дополнительным профессиональным образовательным программам».</mixed-citation><mixed-citation xml:lang="en">Письмо Минздравсоцразвития РФ от 18.04.2012. № 16-2/10/2-3902«О порядке организации и проведения практической подготовки по основным образовательным программам среднего, высшего и послевузовского медицинского или фармацевтического образования и дополнительным профессиональным образовательным программам».</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">«Предложения по переходу к системе аккредитации специалистов в Российской Федерации» Минздрава РФ [Электронный ресурс] // URL: www.rosminzdrav.ru (дата обращения 06.01.2015).</mixed-citation><mixed-citation xml:lang="en">«Предложения по переходу к системе аккредитации специалистов в Российской Федерации» Минздрава РФ [Электронный ресурс] // URL: www.rosminzdrav.ru (дата обращения 06.01.2015).</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Горшков М.Д. Вопросы классификации симуляционного обучения / М.Д. Горшков // Симуляционное обучение в медицине. - М.: Изд-во Первого МГМУ им. И.М. Сеченова, 2013. - С. 54-73.</mixed-citation><mixed-citation xml:lang="en">Горшков М.Д. Вопросы классификации симуляционного обучения / М.Д. Горшков // Симуляционное обучение в медицине. - М.: Изд-во Первого МГМУ им. И.М. Сеченова, 2013. - С. 54-73.</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Лебедев В.В. Программа обучения клинических ординаторов по специальности «Нейрохирургия» / В.В. Лебедев, В.В. Крылов // Нейрохирургия. - 2003. - № 3. - С. 60-65.</mixed-citation><mixed-citation xml:lang="en">Лебедев В.В. Программа обучения клинических ординаторов по специальности «Нейрохирургия» / В.В. Лебедев, В.В. Крылов // Нейрохирургия. - 2003. - № 3. - С. 60-65.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Худасова А. Отвечая вызовам времени // Медицинская газета. - 2015. - № 32. - C. 4.</mixed-citation><mixed-citation xml:lang="en">Худасова А. Отвечая вызовам времени // Медицинская газета. - 2015. - № 32. - C. 4.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Bokhari A.R. Endoscopic transsphenoidal pituitary surgery: a single surgeon experience and the learning curve / A.R. Bokhari, M. A. Davies, T. Diamond // Br. J. Neurosurg. - 2013. - Vol. 27. - №. 1. - P. 44-49.</mixed-citation><mixed-citation xml:lang="en">Bokhari A.R. Endoscopic transsphenoidal pituitary surgery: a single surgeon experience and the learning curve / A.R. Bokhari, M. A. Davies, T. Diamond // Br. J. Neurosurg. - 2013. - Vol. 27. - №. 1. - P. 44-49.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Da Silva C.E. Microsurgical cipping of the anterior circulation aneurysms: study of a personal series and a critical literature review / C.E. Da Silva, de Freitas P.E., Romero A.C. et al. // JBNC. - 2009. - Vol. 20. - №. 4. - P. 409-414.</mixed-citation><mixed-citation xml:lang="en">Da Silva C.E. Microsurgical cipping of the anterior circulation aneurysms: study of a personal series and a critical literature review / C.E. Da Silva, de Freitas P.E., Romero A.C. et al. // JBNC. - 2009. - Vol. 20. - №. 4. - P. 409-414.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Elsmore A. J. The operative learning curve for vestibular schwannoma excision via the retrosigmoid approach / A. J. Elsmore, N. D. Mendoza // Br. J. Neurosurg. - 2002. - Vol. 16. - №. 5. - P. 448-455.</mixed-citation><mixed-citation xml:lang="en">Elsmore A. J. The operative learning curve for vestibular schwannoma excision via the retrosigmoid approach / A. J. Elsmore, N. D. Mendoza // Br. J. Neurosurg. - 2002. - Vol. 16. - №. 5. - P. 448-455.</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Gasco G. Neurosurgery simulation in residency training: feasibility, cost, and educational benefit / G. Gasco, T. J. Holbrook, Patel A. et al. // Neurosurg. - 2013. - Vol. 73. - № 4. - P. S39-45.</mixed-citation><mixed-citation xml:lang="en">Gasco G. Neurosurgery simulation in residency training: feasibility, cost, and educational benefit / G. Gasco, T. J. Holbrook, Patel A. et al. // Neurosurg. - 2013. - Vol. 73. - № 4. - P. S39-45.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Gonzalvo A. The learning curve of pedicle screw placement: how mane screws are enough? / A. Gonzalvo, G. Fit, S. Liew et al. // Spine. - 2009. - Vol. 34. - № 21. - P. 761-765</mixed-citation><mixed-citation xml:lang="en">Gonzalvo A. The learning curve of pedicle screw placement: how mane screws are enough? / A. Gonzalvo, G. Fit, S. Liew et al. // Spine. - 2009. - Vol. 34. - № 21. - P. 761-765</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Haut E.R. Surgeon- and system-based influences on trauma mortality / E.R. Haut, D.C. Chang, A.J. Hayanga et al. // Arch. Surg. - 2009. - Vol. 144. - № 8. - Р. 759-764.</mixed-citation><mixed-citation xml:lang="en">Haut E.R. Surgeon- and system-based influences on trauma mortality / E.R. Haut, D.C. Chang, A.J. Hayanga et al. // Arch. Surg. - 2009. - Vol. 144. - № 8. - Р. 759-764.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Hsu H.T. Learning curve of full-endoscopic lumbar discectomy / H.T. Hsu, S.J. Chang, S.S. Yang, C.L. Chai // Eur. Spine. - 2013. - Vol. 22. - №. 4. - P. 727-733.</mixed-citation><mixed-citation xml:lang="en">Hsu H.T. Learning curve of full-endoscopic lumbar discectomy / H.T. Hsu, S.J. Chang, S.S. Yang, C.L. Chai // Eur. Spine. - 2013. - Vol. 22. - №. 4. - P. 727-733.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Imagama S. Perioperative complications and adverse events after lumbar spinal surgery: evaluation of 1012 operations at single center / S. Imagama, N. Kawakami, T. Tsuji et al. // J. Orthop. Sci. - 2011. - Vol. 16. - № 5. - P. 510-515.</mixed-citation><mixed-citation xml:lang="en">Imagama S. Perioperative complications and adverse events after lumbar spinal surgery: evaluation of 1012 operations at single center / S. Imagama, N. Kawakami, T. Tsuji et al. // J. Orthop. Sci. - 2011. - Vol. 16. - № 5. - P. 510-515.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Ko K. Training protocol for intracranial pressure monitor placement by nonneurosurgeons: 5-year experience / K. Ko, A. Conforti A. // J. Trauma. - 2003. - Vol. 55. - № 3. - P. 480-483.</mixed-citation><mixed-citation xml:lang="en">Ko K. Training protocol for intracranial pressure monitor placement by nonneurosurgeons: 5-year experience / K. Ko, A. Conforti A. // J. Trauma. - 2003. - Vol. 55. - № 3. - P. 480-483.</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Mauer U. M. Management of neurotrauma by surgeons and orthopedists in a military operational setting / U. M. Mauer, U. Kunz // J. Neurosurg. - 2010. - Vol. 28. - № 5. P. E10</mixed-citation><mixed-citation xml:lang="en">Mauer U. M. Management of neurotrauma by surgeons and orthopedists in a military operational setting / U. M. Mauer, U. Kunz // J. Neurosurg. - 2010. - Vol. 28. - № 5. P. E10</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Maurice-Williams R.S. Intracranial aneurism surgery and its future / R.S. Maurice-Williams, J. Lafuente // JRSM. - 2003. - Vol. 96. - №. 11. - P. 540-543.</mixed-citation><mixed-citation xml:lang="en">Maurice-Williams R.S. Intracranial aneurism surgery and its future / R.S. Maurice-Williams, J. Lafuente // JRSM. - 2003. - Vol. 96. - №. 11. - P. 540-543.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">McLoughlin G.S. The learning curve of minimally-invasive lumbar discectomy / G.S. McLoughlin, D.R. Fourney // Can. J. Neurol. Sci. - 2008. - Vol. 35. - №. 1. - P. 75-78.</mixed-citation><mixed-citation xml:lang="en">McLoughlin G.S. The learning curve of minimally-invasive lumbar discectomy / G.S. McLoughlin, D.R. Fourney // Can. J. Neurol. Sci. - 2008. - Vol. 35. - №. 1. - P. 75-78.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Nowitzke A.M. Assessment of the learning curve for lumbar microendoscopic discectomy / A.M. Nowitzke // Neurosurgery. - 2005. - Vol. 56. - №. 4. - P. 755-762.</mixed-citation><mixed-citation xml:lang="en">Nowitzke A.M. Assessment of the learning curve for lumbar microendoscopic discectomy / A.M. Nowitzke // Neurosurgery. - 2005. - Vol. 56. - №. 4. - P. 755-762.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">O'Malley B.W. Comparison of endoscopicand microscopic removal of pituitary adenomas: single-surgeon experience and the learning curve / B.W. O'Malley, M.S. Grady, B.C. Gabel et al. // Neurosurg. Focus. - 2008. - Vol. 25. - №. 6. - P. E10.</mixed-citation><mixed-citation xml:lang="en">O'Malley B.W. Comparison of endoscopicand microscopic removal of pituitary adenomas: single-surgeon experience and the learning curve / B.W. O'Malley, M.S. Grady, B.C. Gabel et al. // Neurosurg. Focus. - 2008. - Vol. 25. - №. 6. - P. E10.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Parikh K. Operative results and learning curve: microscope-assisted tubular microsurgery for 1- and 2-level diskectomies and laminectomies / K. Parikh, A. Tomasino, J. Knopman et al. // Neurosurg. Focus. - 2008. - Vol. 25. - №. 2. - P. E14.</mixed-citation><mixed-citation xml:lang="en">Parikh K. Operative results and learning curve: microscope-assisted tubular microsurgery for 1- and 2-level diskectomies and laminectomies / K. Parikh, A. Tomasino, J. Knopman et al. // Neurosurg. Focus. - 2008. - Vol. 25. - №. 2. - P. E14.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Rong L. M. Spinal surgeons learning curve for lumbar microendoscopic discectomy: a prospective study of our first 50 and lastest 10 cases / L. M. Rong, xie P. G. D. H. Shi et al. // Chin. Med. J. (Engl). - 2008. - Vol. 121. - №. 21. - P. 2148-2151.</mixed-citation><mixed-citation xml:lang="en">Rong L. M. Spinal surgeons learning curve for lumbar microendoscopic discectomy: a prospective study of our first 50 and lastest 10 cases / L. M. Rong, xie P. G. D. H. Shi et al. // Chin. Med. J. (Engl). - 2008. - Vol. 121. - №. 21. - P. 2148-2151.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Selden N.R. Model-based simulation for early neurosurgical learners / N.R. Selden, T.C. Origitano, C. Hadjipanayis et al. // Neurosurg. - 2013. - Vol. 73. - № 4. - P. 15-24.</mixed-citation><mixed-citation xml:lang="en">Selden N.R. Model-based simulation for early neurosurgical learners / N.R. Selden, T.C. Origitano, C. Hadjipanayis et al. // Neurosurg. - 2013. - Vol. 73. - № 4. - P. 15-24.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Stienen M.N. Early surgical education of residents is safe for microscopic lumbar disk surgery / M.N. Stienen, N. Smoll, G. Hildebrandt et al. // Acta. Neuroschir. (Wien). - 2014. - Vol. 156. - № 6. - P. 1205-1214.</mixed-citation><mixed-citation xml:lang="en">Stienen M.N. Early surgical education of residents is safe for microscopic lumbar disk surgery / M.N. Stienen, N. Smoll, G. Hildebrandt et al. // Acta. Neuroschir. (Wien). - 2014. - Vol. 156. - № 6. - P. 1205-1214.</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Von Lehe M. A comprehensive analysis of early outcomes and complication rates after 769 craniotomies in pediatric patients / M. von Lehe, H.J. Kim, J. Schramm, M. Simon // Childs. Nerv. Syst. - 2013. - Vol. 29. - № 5. - P. 781-790.</mixed-citation><mixed-citation xml:lang="en">Von Lehe M. A comprehensive analysis of early outcomes and complication rates after 769 craniotomies in pediatric patients / M. von Lehe, H.J. Kim, J. Schramm, M. Simon // Childs. Nerv. Syst. - 2013. - Vol. 29. - № 5. - P. 781-790.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Wang. A.Y. The vestibular schwannoma surgery learning curve mapped by the cumulative summation test for learning curve / A.Y. Wang, J. T. Wang, M. Dexter, M. Da Cruz // Otol. Neurotol. - 2013. - Vol. 34. - №. 8. - P. 1469-1475.</mixed-citation><mixed-citation xml:lang="en">Wang. A.Y. The vestibular schwannoma surgery learning curve mapped by the cumulative summation test for learning curve / A.Y. Wang, J. T. Wang, M. Dexter, M. Da Cruz // Otol. Neurotol. - 2013. - Vol. 34. - №. 8. - P. 1469-1475.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
