手术技能三阶段培训对泌尿外科住院医师腹腔镜手术技能提升效果分析——以腹腔镜肾囊肿去顶术为例  

Analysis of the improvement effect of three-stages training of surgical skills on laparoscopic surgery skills of surgical residents:taking laparoscopic unroofing of renal cyst as an example

作　　者：马琳[1] 柳琪林[2] 纪志刚[1] 黄钟明[1] Ma Lin;Liu Qilin;Ji Zhigang;Huang Zhongming(Department of Urology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Resident Training,Chinese Medical Doctor Association,Beijing 100027,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 [2]中国医师协会住培部,北京100027

出　　处：《中国毕业后医学教育》2023年第1期50-54,共5页Chinese Journal of Graduate Medical Education

基　　金：北京协和医学院2020年中央高校教育教学改革专项资金支持项目(2020zlgc0103)。

摘　　要：目的以腹腔镜肾囊肿去顶术为例探讨手术技能三阶段培训模式对外科(泌尿外科方向)住院医师腹腔镜手术技能的提高作用。方法将参与中国医师协会主办的外科临床实践技能三阶段培训项目的73名第二年外科(泌尿外科方向)住院医师纳入观察组,通过器具模拟和动物离体器官培训腹腔镜操作。同基地、同专业的29名第3年外科住院医师作为对照组,通过传统带教手术进行培训。培训前后对两组住院医师手术操作水平进行评估,并收集住院医师对技能培训的反馈评价。结果腹腔镜肾囊肿去顶术术式技能考核成绩显示,观察组培训前考核成绩低于对照组,而培训后成绩明显高于对照组,差异均具有统计学意义(均P<0.05);培训后观察组所有住院医师考核均达到合格。通过该培训,有信心在临床工作中实操该术式的住院医师由16.4%升高至58.9%,住院医师对该培训课程满意度为97.3%。结论应用手术技能三阶段培训可显著提高住院医师腹腔镜手术技能,增强实操腹腔镜手术的信心,值得在住院医师手术教学中推广。Objective Taking laparoscopic unroofing of renal cyst as an example to explore the effect of the three-stages of training on the improvement of laparoscopic surgical skills of urology residents.Methods 73junior residents(urology)who participated in the three-stage training program of surgical skills organized by The Chinese Medical Doctor Association were selected as the experimental group.They were trained in laparoscopic surgical skills and procedures of laparoscopic unroofing of renal cyst through laparoscopic training box and animal organ simulator in vitro.29 Senior residents(urology)from the same standardized training base of residents served as the control group who received laparoscopic surgical skills training through traditional surgical teaching.Before and after the training,surgical performance of the two groups of residents was evaluated by scales,and residents’feedback on skill training was collected.Results The skill assessment results of laparoscopic unroofing of renal cyst showed that the score of the experimental group was lower than that of the control group before training,and the score was significantly higher than that of the control group after training(all P<0.05).After the training,all the residents in the experimental group were qualified.The number of residents who were confident in performing the operation increased from 16.4%to 58.9%after the training,and the satisfaction of residents to the training program reached 97.3%.Conclusion The application of the three-stage training of surgical skills can significantly improve the laparoscopic surgery skills of residents and enhance their confidence in laparoscopic surgery,which has great popularization in the surgical teaching of residents.

关 键 词：外科 住院医师 规范化培训 腹腔镜手术 手术技能培训 

分 类 号：G423[文化科学—课程与教学论] R699[文化科学—教育学]