麻醉学专业住院医师纤维支气管镜关键技术分段培训模式探索  

Exploration of a segmented training model for anesthesiology residents in key fiberoptic bronchoscopy techniques

作　　者：张昱昊 黄燕华[1] 李强[1] 徐怡琼[1] 郭茜[1] 徐悦 罗艳[1] 史霆[2] 严俊[1] Zhang Yuhao;Huang Yanhua;Li Qiang;Xu Yiqiong;Guo Qian;Xu Yue;Luo Yan;Shi Ting;Yan Jun(Departement of Anesthesiology,Rujin Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200025,China;Office of Continuing Education,Ruijin Hospital Affliated to Shanghai Jiaotong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院麻醉科,上海200025 [2]上海交通大学医学院附属瑞金医院医学教育处,上海200025

出　　处：《中华医学教育探索杂志》2024年第10期1319-1325,共7页Chinese Journal of Medical Education Research

摘　　要：目的研究纤维支气管镜关键技术分段培训模式对麻醉学专业住院医师的总体培训效果及各关键技术培训的先后顺序对培训效果的影响。方法使用不同纤支镜模拟器可分别对纤支镜操作的不同关键技术进行专门培训。为检验不同关键技术学习顺序对教学效果的影响,本研究选择2022年11月至2023年3月在上海交通大学医学院附属瑞金医院参加纤支镜模拟培训的麻醉学专业住院医师40人,用数字表法随机分为两组(S组和M组),使用2种不同的教学顺序完成教学,记录两组学员培训后的操作用时、操作质量评分和理论知识掌握评分,以比较不同关键技术学习顺序对于纤支镜技能掌握效果的影响。采用SPSS 29.0统计软件对数据进行分析。符合正态分布的计量资料数据以(均数±标准差)表示,采用独立样本t检验或Fisher确切概率法进行组间比较;计数资料比较采用卡方检验。结果两组学员在经过各关键技术分段培训后均能缩短该项关键技术的操作用时[S组学员SM模拟器用时(132.25±14.69)s vs.(49.80±4.46)s,P<0.01;M模拟器用时(82.30±11.60)s vs.(57.10±6.77)s,P<0.01;M组学员SM模拟器操作用时(83.10±10.62)s vs.(52.10±5.20)s,P<0.01,M模拟器用时(132.25±14.69)s vs.(55.40±5.91)s,P<0.01],减少碰壁次数[S组学员SM模拟器碰壁次数(3.35±0.93)次vs.(0.65±0.49)次,P<0.01,M模拟器碰壁次数(2.50±1.05)次vs.(0.70±0.80)次,P<0.01;M组学员SM模拟器碰壁次数(1.55±1.15)次vs.(0.40±0.50)次,P<0.01,M模拟器碰壁次数(5.90±1.29)次vs.(1.10±0.79)次,P<0.01]。两组学员完成培训内容后其纤支镜引导气管插管表现得分[(92.50±5.97)分vs.(91.75±5.45)分]和肺段定位时间[(23.15±4.39)s、(21.40±4.84)s、(22.85±4.42)s vs.(22.75±5.11)s、(21.00±5.40)s、(21.50±5.10)s]差异均无统计学意义。结论纤支镜关键技术分段培训是有效的麻醉学专业住院医师纤支镜培训模式,关键技术的培训顺序不影�Objective To study the overall training effect of segmented training model on key fiberoptic bronchoscopy techniques for anesthesiology residents and the influence of key technique training order on the training effect.Methods Different fiberoptic bronchoscopy simulators were used for specialized training in different key techniques of fiberoptic operation.To examine the effect of key technique learning order on the teaching effect,40 anesthesiology residents who participated in fiberscope simulation training at Ruijin Hospital,Shanghai Jiaotong University School of Medicine between November 2022 and March 2023 were selected for this study.They were randomly divided into two groups(Group S and Group M)using a numerical table method.The teaching was completed using two orders of key techniques.The operation time,operation quality score,and theoretical knowledge mastery score of the two groups were recorded to compare the effect of key technique learning order on the mastery of fiberoptic skills.SPSS 29.0 statistical software was used for data analysis.Measurement data that conformed to normal distribution were expressed as mean±standard deviation,and the independent samples t-test or Fisher's exact test were used for comparison between groups.The chi-square test was used for comparison of enumeration data.Results After segmented training in each key technique,both groups of trainees were able to shorten the operation time of the corresponding key technique[SM simulator operation time(132.25±14.69)s vs.(49.80±4.46)s in group S,P<0.01;M simulator operation time(82.30±11.60)s vs.(57.10±6.77)s in group S,P<0.01;SM simulator operation time(83.10±10.62)s vs.(52.10±5.20)s in group M,P<0.01;M simulator operation time(132.25±14.69)s vs.(55.40±5.91)s in group M,P<0.01].Moreover,both groups showed a reduced number of wall touches[SM simulator wall touches(3.35±0.93)times vs.(0.65±0.49)times in group S,P<0.01;M simulator wall touches(2.50±1.05)times vs.(0.70±0.80)times in group S,P<0.01;SM simulator wall touches(

关 键 词：分段式教学法 纤维支气管镜 技能模拟培训 麻醉 

分 类 号：R4[医药卫生—临床医学]