情景模拟教学在外科住院医师腹腔镜技能培训中的应用  

The application of scenario simulation teaching in laparoscopic skills training for surgical residents

作　　者：王敏[1] 顾海涛[1] 吴珺艺 龚锦[2] 韩晓玲[2] 段茗玉[2] 裘正军[1] 刘玮[2] 吴卫东[1] WANG Min;GU Hai-tao;WU Jun-yi(Department of General Surgery,Shanghai Jiao Tong University Affiliated First People’s Hospital,Shanghai 200080,China)

机构地区：[1]上海交通大学附属第一人民医院普通外科,上海200080 [2]上海交通大学附属第一人民医院教育处

出　　处：《腹腔镜外科杂志》2021年第7期546-549,共4页Journal of Laparoscopic Surgery

基　　金：上海交通大学2020年教育教学研究项目(JYJX200024);中华医学会2018年医学教育研究立项课题(2018B-N08005)。

摘　　要：目的:评估情景模拟教学在外科住院医师腹腔镜技能培训中的作用。方法:选取2018~2020年进行住院医师规范化培训的43名学员,随机分为实验组(n=22)与对照组(n=21)。实验组采用情景模拟教学法进行腹腔镜技能培训,对照组采用传统腹腔镜技能培训方法。采用医学模拟情景引导性反馈评分量表评估情景模拟教学的实施效果;采用短时压力状态问卷量表评估培训学员在完成技能培训时的心理应激情况。结果:医学模拟情景引导性反馈评分显示,实验组在“建立引人入胜的学习环境”“保持引人入胜的学习环境”“唤起高参与度的讨论”“识别实际表现与期望的差异”“帮助学员达到或维持良好表现”方面的得分高于对照组。短时压力状态问卷评分显示,实验组学员的投入度、焦虑度高于对照组,但两组在完成训练任务时的苦恼度方面差异无统计学意义。结论:情景模拟教学法可在外科住院医师腹腔镜技能培训中的应用成功构建良好的仿真环境,学员能感受到更接近真实临床工作时所产生的心理情绪变化。Objective:To evaluate the effect of scenario simulation teaching in laparoscopic skills training for surgical residents.Methods:A total of 43 surgical residents received standardized resident training from 2018 to 2020 were randomly divided into experimental group(n=22)and control group(n=21).The experimental group adopted the scene simulation teaching method of laparoscopic skills training,while the control group adopted the traditional laparoscopic skills training method.Debriefing assessment for simulation in healthcare scale was used to evaluate the implementation effect of scenario simulation teaching,and short stress state questionnaire scale was used to evaluate the psychological stress of the trainees when they completed the skill training.Results:Debriefing assessment for simulation in healthcare scores showed that the scores of the experimental group were higher than those of the control group in items of"establish an engaging learning environment","maintain an engaging learning environment","provoke engaging discussions","identify differences between actual performance and expectations"and"help trainees achieve or sustain good performance".Short stress state questionnaire score showed that the degree of"task engagement"and"worries"in the experimental group was significantly higher than that of the control group,but there was no significant difference in the degree of"distress"between two groups.Conclusions:The application of scenario simulation teaching method in laparoscopic skills training of surgical residents could successfully construct an excellent simulation environment.In the scenario simulation environment,trainees can feel the psychological and emotional changes closer to the real clinical work.

关 键 词：情景模拟教学 腹腔镜检查 技能培训 住院医师规范化培训 

分 类 号：R656[医药卫生—外科学]