改良三步法在八年制医学生腹腔镜技能培训中的应用  

Application of modified three-step method in laparoscopic skills training for eight-year program medical students

作　　者：任淼 刘芃昊 俞亦奇 黄警 孙宇宁 东洁[1] 纪志刚[1] REN Miao;LIU Penghao;YU Yiqi;HUANG Jing;SUN Yuning;DONG Jie;JI Zhigang(Department of Urology,Peking Union Medical College Hospital,CAMS&PUMC,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院泌尿外科,北京100730

出　　处：《基础医学与临床》2023年第2期356-359,共4页Basic and Clinical Medicine

基　　金：北京协和医学院2021年中央高校教育教学改革专项资金支持项目(2021zlgc0103)。

摘　　要：目的评价改良三步法(理论知识,基础技能,实际操作)对临床医学八年制医学生腹腔镜技能的提升效果。方法随机选择北京协和医学院八年制正在实习或刚实习后的、无腹腔镜技能操作经验的6名医学生作为实验组,进行为期10周,每周1次,每次3 h的改良三步法腹腔镜基本操作技能培训,并以同期6名医学生为对照。比较培训开始、培训结束时医学生在精准夹豆、加难夹豆、梅花桩夹豆、仿肉缝合、钝性分离、超声刀分离、超声刀切割、单纯间断缝合、连续缝合、淋巴清扫共10项基本技能操作水平。结果培训结束时,相比于对照组,实验组医学生在精准夹豆、加难夹豆、梅花桩夹豆、仿肉缝合、超声刀分离、超声刀切割、连续缝合共7项的操作用时明显更少或得分明显更高(P<0.05)。结论改良三步法的培训可以显著提高八年制医学生的腹腔镜基本技能操作水平,为正式开展临床手术工作打下牢固基础,是一种令医学生满意的培训方式。Objective To evaluate the improvement effect of the modified three-step method(theoretical knowledge,basic skills,practical operation)applied in the training of laparoscopic skills of Eight-year Program of Clinical Medical students.Methods A total of 6 medical students in Peking Union Medical College who were in practice or just after practice and had no experience in laparoscopic operation were randomly selected as the experimental group for a period of 10 weeks,one time a week,3 hours each time of modified three-step laparoscopic basic operation skills training and 6 medical students during the same period were trained by tradional method used as the control.The level of basic skill operation of medical students was evaluated at the beginning and at the end of the training in 10 items:basic clamping,advanced clamping,pile clamping,imitation meat suture,blunt separation,ultrasonic knife separation,ultrasonic knife cutting,simple intermittent suture,continuous suture,and lymphatic dissection.Results At the end of the training,students of experimental group performed better in 7 items of basic clamping,advanced clamping,pile clamping,imitation meat suture,ultrasonic knife separation,ultrasonic knife cutting and continuous suture.The operation time was significantly reduced or the score was significantly improved(P<0.05).Conclusions The training of the improved three-step method can significantly improve the basic skills of laparoscopic operation of eight-year medical students,lay a solid foundation for the formal clinical operation and is an effective training method for medical students.

关 键 词：改良三步法 八年制医学生 腹腔镜技能培训 

分 类 号：G642[文化科学—高等教育学]