外科专业基地住院医师规范化培训入科教育技能教学实践  

Skills teaching practice of department-entrance education of standardized residency training in surgery department

作　　者：黄利军[1] 唐骁 魏波[1] 邓美海[2] 卫洪波[1] Huang Lijun;Tang Xiao;Wei Bo;Deng Meihai;Wei Hongbo(Department of Gastrointestinal Surgery,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Hepatobiliary Surgery,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China)

机构地区：[1]中山大学附属第三医院胃肠外科,广州510630 [2]中山大学附属第三医院肝胆外科,广州510630

出　　处：《中华医学教育探索杂志》2020年第12期1465-1468,共4页Chinese Journal of Medical Education Research

基　　金：中山大学医学教育类CAI课题项目(82000-16300009)。

摘　　要：目的探索外科专业基地住院医师规范化培训入科教育技能教学需注意的问题。方法对即将进入住院医师规范化培训的外科专业基地医师(简称"入培医师")行以腹腔镜培训为主的入科教育技能教学。首先进行腹腔镜基本理论教学,然后行外科基本操作培训以及腹腔镜模拟箱操作培训。外科基本操作培训包括伤口换药;切开、缝合、打结、剪线;洗手、消毒、铺巾、穿脱手术衣;腹腔镜模拟箱操作培训包括剪纸片、缝合打结。培训结束后进行理论及操作考核,同时发放并回收调查问卷。采用SPSS 21.0统计软件进行统计分析,计量资料用t检验,计数资料用卡方检验。结果56位入培医师均完成培训及考核。腹腔镜理论考核结果显示入培医师对腹腔镜器械及其使用方式认识不足,正确率仅24.1%;但是对气腹建立及管理、腹腔镜手术适应证及禁忌证、腹腔镜手术优势认识较好,正确率分别为87.5%、93.3%、100%。外科基本操作考核结果显示入培医师操作完成度合格率高,为89.3%;无菌观念合格率低,为32.1%。腹腔镜操作考核结果显示相较于培训前,培训后剪纸片及缝合打结用时显著缩短(P<0.001),合格率显著提高(P<0.001)。96.4%的入培医师对入科教育内容及结果满意。结论短期以腹腔镜培训为主的入科教育可以提升入培医师的腹腔镜技能,但是仍需注意加强培养无菌观念和腹腔镜技能。Objective To explore the problems that should be noticed in the department-entrance education of standardized residency training in surgery department.Methods The residents who would enter the standardized residency training in surgery department(referred to as"training residents")were given department-entrance education based on laparoscopic training.After teaching of laparoscopic theory,they got basic surgery skills training and laparoscopic surgical box model training.The basic surgery skills training included wound dressing change,cutting,stitching,knotting,shearing,hand washing,sterilizing and drape placing,and wearing and taking off surgical gowns.The laparoscopic surgical box model training contained scrip shearing,suturing and knotting.After the training,the residents were evaluated by theory and skills examination and questionnaire at the same time.SPSS 21.0 was used for statistical analysis,t test for measurement data,and chi-square test for counting data.Results All 56 residents completed the training and examinations.The theory examination showed that the residents had poor knowledge of laparoscopic instruments and their use methods,with the correct rate only 24.1%.However,they did well in the establishment and management of pneumoperitoneum,indications and contraindications of laparoscopic surgery,and advantages of laparoscopic surgery,and the correct rates were 87.5%,93.3%,100%respectively.The results of basic surgery skills showed a high correct rate of the residents in the operation completion(89.3%),but low in the aseptic concept(32.1%).Compared with the previous records before laparoscopic training,they made significant improvement of time cost in the scrip shearing,suturing and knotting(P<0.001),and the qualified rate was also significantly improved(P<0.001).A percent of 96.4%of residents were satisfied with contents and results of the department-entrance education.Conclusion The short-term training of department-entrance education based on laparoscopy could effectively improve the laparoscopic

关 键 词：住院医师规范化培训 入科教育 外科专业基地 腹腔镜 

分 类 号：R6[医药卫生—外科学]