基于“Miller金字塔”原理的分层教学模式在妇科腹腔镜模拟教学中的应用  

Application of hierarchical teaching mode based on"Miller pyramid"theory in simulation teaching of gynecological laparoscopy

作　　者：张丹丹[1,2] 李佳[3] 张明杰[2,3] 宋子璇[1] 王晓雪[2] ZHANG Dandan;LI Jia;ZHANG Mingjie;SONG Zixuan;WANG Xiaoxue(Shengjing Hospital of China Medical University Department of Obstetrics and Gynecology,Shenyang 110004,China;Shengjing Hospital of China Medical University Graduate Medical Training Department,Shenyang 110004,China;Shengjing Hospital of China Medical University Department of Surgery,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院妇产科教研室,沈阳110004 [2]中国医科大学附属盛京医院毕业后培训部,沈阳110004 [3]中国医科大学附属盛京医院外科教研室,沈阳110004

出　　处：《中国医学教育技术》2022年第1期70-74,101,共6页China Medical Education Technology

摘　　要：目的观察基于"Miller金字塔"原理的分层教学模式在妇科腹腔镜模拟教学中的应用效果。方法以病房为单位按整群抽样法,将2019级全体妇产科住院医师分为试验组和对照组,每组各30人;对照组采用传统的教学模式,试验组采用将基于"Miller金字塔"原理的分层教学模式应用于腹腔镜模拟培训箱和手术模拟器的教学中。培训后,考核两组住院医师腹腔镜基础操作能力;应用客观结构化技能评价评分系统(OSATS)进行手术模拟考核,并在考核后完成教学满意度调查。结果完成6个月的培训后,试验组住院医师的腹腔镜基本操作技术考核成绩均显著高于对照组(P<0.001);试验组和对照组住院医师的手术模拟考核OSATS评分,在培训后较培训前均显著提高(P<0.05),但试验组的操作质量评分显著高于对照组(P<0.001),且操作完成用时显著少于对照组(P<0.001)。试验组在兴趣程度、可参与性、掌握程度和教学满意度上,均高于对照组,在学习难易程度上低于对照组,差异具有统计学意义(P<0.001)。结论基于"Miller金字塔"原理的分层教学模式在妇科住院医师腹腔镜技能培训中的应用效果优于传统的教学方法,值得进一步推广。Objective To observe the application effect of hierarchical teaching mode based on"Miller pyramid"theory in simulation teaching of gynecological laparoscopy.Methods According to cluster sampling method,all residents of the department of obstetrics and gynecology in the class of 2019 were divided into the experimental group and the control group,with 30 residents in each.The control group used traditional teaching mode,while hierarchical teaching mode based on"Miller pyramid"theory was applied in the teaching of laparoscopic training box and laparoscopic surgery simulator of the experimental group.After the training,residents’basic laparoscopic techniques were assessed.Objective structured assessment of technical skills(OSATS)was applied to conduct operation simulation test,and satisfaction survey of teaching was completed after the test.Results After 6 months of training,residents in the experimental group had significantly better performance in basic laparoscopic techniques than those in the control group(P<0.001).The OSATS scores of the experimental group and the control group were significantly higher after the training than before(P<0.05),but the operation quality score of the experi-mental group was significantly higher than that of the control group(P<0.001),and they used significantly less time to complete operation than the control group(P<0.001).The experi-mental group gave higher scores in the degree of interest,participation,mastery and teaching satisfaction,and lower scores in the degree of learning difficulty than the control group.The difference was statistically significant(P<0.05).Conclusion Hierarchical teaching mode based on"Miller pyramid"theory obtained better application effect in simulation teaching of gynecological laparoscopy than traditional teaching method,and it is worthy of further promotion.

关 键 词：Miller金字塔模式 分层教学 妇产科 住院医师规范化培训 腹腔镜教学 模拟教学 

分 类 号：G434[文化科学—教育学] G642.0[文化科学—教育技术学]