一种鼓膜穿刺模型及其在耳鼻咽喉科教学实践中的应用  

A model of tympanic membrane puncture and its application in otolaryngology teaching practice

作　　者：段祥强 何建乔 朱敏辉 高颖娜 李孟 郑宏良 周义德 Duan Xiangqiang;He Jianqiao;Zhu Minhui;Gao Yingna;Li Meng;Zheng Hongliang;Zhou Yide(Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院耳鼻咽喉头颈外科,上海200433

出　　处：《中国毕业后医学教育》2024年第5期356-359,364,共5页Chinese Journal of Graduate Medical Education

基　　金：国家自然科学基金(81970868);国家自然科学基金(81400455);海军军医大学第一附属医院234学科攀登计划(2020YXK037)。

摘　　要：目的设计一种鼓膜穿刺模型,并将该模型应用到教学中,探讨其在鼓膜穿刺术培训中的价值。方法利用简易装置设计一种鼓膜穿刺模型,将该模型应用于鼓膜穿刺术培训。选取的培训对象为海军军医大学2019级八年制无军籍学员37人,将学员随机分入实验教学组和常规教学组,其中实验教学组18人,常规教学组19人。两组同时进行常规理论授课,理论授课结束后进行临床见习;临床见习结束后,实验教学组进行鼓膜穿刺模型实践操作4学时,常规教学组观看鼓膜穿刺教学视频4学时。课程结束后,分别对两组行综合能力自我评估和手术操作考核评估。结果教学效果评价显示,实验教学组综合能力自我评估得分显著高于常规教学组[(88.22±3.04)分比(77.95±2.87)分,P<0.01],实验教学组专业学习兴趣、实践操作能力显著高于常规教学组(均P<0.01);实验教学组手术操作考核评估得分显著高于常规教学组[(73.72±3.30)分比(65.68±2.95)分,P<0.01],实验教学组在解剖结构熟悉情况、操作熟练程度均显著高于常规教学组(均P<0.01)。结论该鼓膜穿刺模型,设计简便,将其应用于临床教学中,可显著提高鼓膜穿刺术成功率,降低不良事件发生率,提高教学效果。Objective To design a model for tympanic membrane puncture and utilize it for educational purposes,while investigating its effectiveness in training for tympanic membrane puncture.Methods Simple devices were utilized to create a model specifically designed for tympanic membrane puncture.The model was then incorporated into a training program conducted with 37 non-military students from the 2019 class of the 8-year program at Naval Medical University.The students were randomly assigned to an experimental teaching group(n=18)and a regular teaching group(n=19).The two groups simultaneously received conventional theoretical instruction followed by clinical practice.Subsequently,the experimental teaching group received 4 sessions of practical exercise using the tympanic membrane puncture model,meanwhile,the regular teaching group received 4 sessions of tympanic membrane puncture teaching video.Following the completion of the training program,both groups were evaluated on their comprehensive abilities and surgical skills.Results The evaluation of teaching effectiveness revealed that the experimental teaching group exhibited significantly higher scores compared with the conventional teaching group in terms of self-assessment of comprehensive ability[(88.22±3.04)points vs(77.95±2.87)points,P<0.01].This difference was primarily observed in professional interest and practical operation ability.Additionally,the assessment of surgical skills demonstrated that the experimental teaching group achieved significantly higher scores than the regular teaching group[(73.72±3.30)points vs(65.68±2.95)points,P<0.01],particularly in terms of familiarity with anatomical structures and proficiency in operation.Conclusion The novel model of tympanic membrane puncture is characterized by a simple design and its implementation in clinical teaching can effectively enhance the success rate of the procedure,decrease the occurrence of adverse events,and improve teaching effectiveness.

关 键 词：鼓膜穿刺模型 模拟教育 综合能力自我评估 手术操作考核评估 

分 类 号：G648[文化科学—高等教育学] R76[文化科学—教育学]