外科住院医师利用动物离体器官训练手术技能的方法与效果观察  

Application and effect analysis of surgical skills training system with ex vivo model in standardized surgical residency training

作　　者：张媛媛[1] 姜冠潮[1] 韩一哲 柳琪林[2] 齐学进[3] Zhang Yuanyuan;Jiang Guanchao;Han Yizhe;Liu Qilin;Qi Xuejin(Clinical Skill Training Center,Peking University People's Hospital,Beijing 100044,China;Department of Resident Training,Chinese Medical Doctor Association,Beijing 100073,China;Chinese Medical Doctor Association,Beijing 100073,China)

机构地区：[1]北京大学人民医院临床能力培训中心,北京100044 [2]中国医师协会住培部,北京100073 [3]中国医师协会,北京100073

出　　处：《中国毕业后医学教育》2023年第1期40-43,共4页Chinese Journal of Graduate Medical Education

摘　　要：目的探索外科住院医师利用动物离体器官进行手术技能训练的方法与效果。方法选取2020年11月至2021年3月期间13家培训基地参加外科住院医师规范化培训(简称住培)的372名外科住院医师,分为观察组和对照组。观察组接受动物离体器官训练系统培训并进行考核,其中,参加开腹阑尾切除术96人次,参加腹腔镜阑尾切除术132人次,参加腹腔镜肾囊肿去顶减压术71人次。对照组接受传统外科带教模式培训后进行考核,接受开腹阑尾切除术考核16人次、腹腔镜阑尾切除术考核26人次、腹腔镜肾囊肿去顶减压术考核29人次。结果观察组三种术式培训后成绩均明显高于培训前成绩(均P<0.05);培训后观察组三种术式成绩均明显高于对照组(均P<0.05)。各培训基地之间培训前三种术式成绩差异显著(P<0.05);培训后各培训基地开腹阑尾切除术、腹腔镜阑尾切除术的考核成绩无显著差异(P>0.05)。结论动物离体器官手术训练可以有效提高外科住院医师开腹阑尾切除术、腹腔镜阑尾切除术、腹腔镜肾囊肿去顶减压术三种术式的外科手术技能,可促进开腹阑尾切除术、腹腔镜阑尾切除术的培训均质化。Objective To explore the effect of the surgical skills training system with ex vivo models in standardized residency training.Methods 372 surgical residents who participated in standardized training in 13 centers from November 2020 to March 2021 were selected and divided into experimental group and control group.The experimental group received the surgical skills training system with ex vivo models,and was assessed before and after the training.Among them,96 residents participated in appendectomy,132 residents participated in laparoscopic appendectomy,and 71 residents participated in laparoscopic unroofing of renal cyst.The control group received the traditional surgical training,16 residents were assessed for appendectomy,26 residents for laparoscopic appendectomy,and 29 residents for laparoscopic unroofing of renal cyst.Results In the experimental group,the scores of three operations after training,were significantly higher than those before training(P<0.05).The scores of the three operation methods in the experimental group were significantly higher than those in the control group(P<0.05).There were significant differences in the examination scores before training among standardized residency training centers(P<0.05).After the training,there were no significant differences in the scores of open appendectomy and laparoscopic appendectomy from the 13 centers(P>0.05).Conclusion Surgical skills training with ex vivo models can effectively improve the surgical skills of surgical residents in three types of operations:appendectomy,laparoscopic appendectomy,and laparoscopic unroofing of renal cyst.This training mode can achieve the homogenization of training in appendectomy and laparoscopic appendectomy in different centers.

关 键 词：外科 住院医师 规范化培训 手术技能培训 离体动物器官 

分 类 号：G423[文化科学—课程与教学论] R656.8[文化科学—教育学] R699[文化科学—教育技术学]