混合模拟工作坊在低年资胸心外科住院医师规范化培训中的应用  

Application of hybrid simulation workshops in standardized training of junior cardiothoracic surgery residents

作　　者：堵俊杰 邵永丰 陈亮[2] 李芝 陆小虎 何志成[2] 周悦[2] 黄华 Du Junjie;Shao Yongfeng;Chen Liang;Li Zhi;Lu Xiaohu;He Zhicheng;Zhou Yue;Huang Hua(Department of Cardiovascular Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing Medical University,Nanjing 210029,Jiangsu,China;Department of Thoracic Surgery,the First Affiliated Hospital of Nanjing Medical University,Nanjing Medical University,Nanjing 210029,Jiangsu,China;Medical Simulation Center,Nanjing Medical University,Nanjing 211166,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院心脏大血管外科,江苏南京210029 [2]南京医科大学第一附属医院胸外科,江苏南京210029 [3]南京医科大学医学模拟教育中心,江苏南京211166

出　　处：《中国毕业后医学教育》2021年第3期250-253,共4页Chinese Journal of Graduate Medical Education

基　　金：2019年南京医科大学教学课题资助项目(NY2252019061)。

摘　　要：目的探讨混合模拟工作坊对低年资胸心外科住院医师在复杂手术切口术后管理技能的提高作用。方法对2019年6月至2020年6月第一次在胸心外科轮转的70名住院医师纳入工作坊学习。通过制定混合模拟形式的临床方案现场教授胸心外科复杂手术切口术后管理的技术性和非技术性技能。使用工作坊表现评分表对住院医师的表现进行评估,要求其完成ARCS学习兴趣量表自我评分。结果通过工作坊的学习,所有住院医师的操作技能都达到了熟练程度(>21分),在沟通能力方面得分较高(83.3%),在基本知识的测试中表现相对较差(66.6%)。高熟练组比低熟练组基本功扎实,引流管护理更好。住院医师对工作坊的好评率81.8%。各项如下:吸引力72.5%、相关性84.4%、自信心80.0%和满意度86.7%。结论在胸心外科住院医师规范化培训中应用混合模拟复杂手术切口术后管理工作坊能提高住院医师相关技术性和非技术性技能的获取,受到住院医师的欢迎,值得进一步在各个培训基地推广应用。Objective To investigate the application of hybrid simulation workshops to improve the postoperative management of complicated surgical wounds after cardiothoracic operations performed by junior residents.Methods From June 2019 to June 2020,the junior residents(n=70)who came to our hospital for the first round of thoracic surgery were recruited in the study.A hybrid simulation clinical program was developed to teach residents'on-site technical skills,non-technical empathy skills and interpersonal communication skills related to the management of complicated surgical wounds after cardiothoracic operations.The workshop performance assessment score was used to evaluate the performance of the trainees.Trainee interested/perceived usefulness of the workshop was evaluated using ARCS Motivational Survey.Results After finishing the workshop training program,all the trainees reached the proficiency level(>21 points).The trainees scored high in communication skills(83.3%),but relatively poor in the basic knowledge test(66.6%).The high proficiency group had higher scores on basic knowledge than the low proficiency group,and had higher scores on drainage tube care.The trainees'attitude towards the workshop was positive(81.8%).The scores of each item of the ARCS survey were as follows:attention(72.5%),relevance(84.4%),confidence(80.0%)and satisfaction(86.7%).Conclusion Hybrid simulation workshops on post-operative management of complicated surgical wounds can improve residents'acquisition of relevant technical and non-technical skills in standardized residency training.Such workshops are welcomed by residents and are worthy of further application and promotion in various residency training bases.

关 键 词：混合模拟 住院医师规范化培训 胸心外科 手术切口 工作坊 

分 类 号：G426[文化科学—课程与教学论] R655[文化科学—教育学]