麻醉临床技能多模态虚拟仿真教学体系建设与实践  

Development and Implementation of a Multimodal Virtual Simulation Teaching System for Clinical Anesthesia Skills

作　　者：龚灿生[1,2] 高飞 解慧泓[1] 郭艳华 郑艇 蒋俊丹[1,2] 郑晓春 GONG Cansheng;GAO Fei;XIE Huihong;GUO Yanhua;ZHENG Ting;JIANG Jundan;ZHENGg Xiaochun(Department of Anesthesiology,Provincial Clinical Medical College of Fujian Medical University,Fujian Provincial Hospital,Fuzhou 350001,China;Fujian Provincial Co-Constructed Laboratory of"Belt and Road",Fujian Emergency Medical Center,Fuzhou 350001,China;Fujian Provincial Key Laboratory of Emergency Medicine,Fujian Emergency Medical Center,Fuzhou 350001,China;Fujian Provincial Key Laboratory of Critical Care Medicine,Fujian Emergency Medical Center,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院,福建省立医院麻醉科,福建福州350001 [2]福建省急救中心,福建省“一带一路”联合共建实验室,福建福州350001 [3]福建省急救中心,福建省急诊医学重点实验室,福建福州350001 [4]福建省急救中心,福建省疑难重症研究重点实验室,福建福州350001

出　　处：《中国医药指南》2023年第22期183-185,F0003,共4页Guide of China Medicine

基　　金：福建医科大学教育教学改革研究项目(J200026);福建医科大学教育教学改革研究项目(J21021);福建省社会发展引导性项目(2021Y0050);福建省本科高校教育教学改革研究重大项目(FBJG20200022)。

摘　　要：目的探索麻醉临床技能培训中视听触觉多模态虚拟仿真教学体系的建设与教学效果评价。方法传统临床带教存在医疗风险高、学习效率低、带教师资少等问题。虚拟仿真教学可弥补现有教学模式的不足之处,本研究将线上线下理论课程、虚拟仿真教学和力反馈技术有机结合,形成视听触觉多模态虚拟仿真教学体系,并以腰硬联合麻醉穿刺为考察项目,纳入20名从未有过椎管穿刺经验的实习医师,随机分为传统教学组(C组)和虚拟仿真教学组(S组),C组接受传统的标准化模拟人穿刺操作培训,S组接受多模态虚拟仿真操作培训教学。培训结束后,各实习医师在高年资主治医师指导下进行腰硬联合麻醉操作。记录学员主动与被动调整穿刺角度的次数、从穿刺开始到硬膜外针刺破黄韧带所需时间,并采用改良椎管内穿刺技能考核评分标准对学员操作进行评分。结果与C组学员相比,S组学员的改良椎管内穿刺技能评分更高[(91.20±2.78)分vs.(86.70±2.87)分,P<0.05];穿刺情况比较,S组学员主动调整穿刺方向的次数显著高于C组(2.0[1.2]vs.1.0[1.0],P<0.05),穿刺开始至突破黄韧带的时间显著缩短[(5.91±1.24)min vs.(8.66±1.19)min,P<0.05]。结论多模态虚拟仿真教学体系可有效提高麻醉临床技能培训的效率和效果,为医学教育质量提升提供了参考。Objectives This study aims to examine the efficiency of a virtual simulation teaching system that integrates visual,auditory,and haptic modalities for clinical skills training in anesthesia.Methods Traditional clinical teaching has been reported to pose challenges such as high medical risks,low learning efficiency,and inadequate qualifications of the educators.To tackle these issues,this study utilized a multimodal virtual simulation teaching system that combined online and offline theoretical courses,virtual simulation teaching,and force feedback technology.The participants comprised twenty interns with no prior experience in lumbar and rigid combined anaesthesia puncture.Group C was trained using a traditional standardized simulator puncture coaching approach,while group S underwent multimodal virtual simulation training.Following the training,each trainee conducted a combined lumbar and rigid anaesthesia procedure under a senior attending physician's supervision.The researchers then recorded the number of active and passive adjustments made to the puncture angle and the duration from the onset of the puncture to piercing the ligamentum flavum using the epidural needle.The participants were also evaluated based on a modified assessment scale for endoluminal puncture skills.This study aims to formulate innovative and effective ways of teaching and training healthcare professionals.Results In comparison to group C participants,group S participants scored higher on modified endospinal puncture skills tests[(91.20±2.78)points vs.(86.70±2.87)points],(P<0.05).Notably,group S participants actively reoriented the puncture more frequently than group C participants in different puncture scenarios(mean frequency of 2.0[1.2]vs.1.0[1.0],P<0.05).Furthermore,group S participants breached the ligamentum flavum in less time than the group C[mean time to breach ligamentum flavum was(5.91±1.24)mins vs.(8.66±1.19)mins,P<0.05].Conclusion The Multimodal Virtual Simulation Teaching System can effectively enhance the efficiency an

关 键 词：虚拟仿真 多模态 技能培训 麻醉学 

分 类 号：R614[医药卫生—麻醉学]