面向自助式模拟教学的麻醉诱导过程性指标设计与可行性探索  

A study of design of a process indicator for anesthesia induction and its feasibility in self-directed simulation-based teaching

作　　者：特日格勒 朱波[1] 张秀华[1] 陈绍辉[1] Te Rigele;Zhu Bo;Zhang Xiuhua;Chen Shaohui(Department of Anesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院麻醉科,北京100730

出　　处：《中华医学教育探索杂志》2024年第12期1625-1630,共6页Chinese Journal of Medical Education Research

基　　金：国家社会科学基金教育学青年课题(CCA220321)。

摘　　要：目的探究应用于自助式模拟教学系统的麻醉诱导过程性指标设计及其可行性,旨在为提高麻醉医师的自主学习和培训质量提供高效的信息化教学工具。方法利用电子病历大数据中麻醉诱导前后收缩压、舒张压和心率这3组血流动力学特征的变异系数,设计麻醉诱导过程性指标,旨在刻画麻醉管理的质量效果。设计调查问卷,并邀请了23位主治及以上级别的麻醉医师对30组案例进行麻醉效果评价,以探讨所设计指标的可行性及其可能的未来应用。数据分析采用SPSS 24.0软件,进行了ANOVA方差分析与相关性分析,检验水准设定为α=0.05。结果根据麻醉诱导过程性指标值所在区间,划分为稳定组、较稳定组、一般稳定组、较不稳定组、不稳定组共5个组别。麻醉医师的评分在组间差异具有统计学意义(F=250.66,P<0.001),这表明综合变异系数(integrated coefficient of variation,ICV)组别对于平稳程度的刻画具有区分性。设计的指标值与麻醉医师的平均评分显著相关,二者的皮尔逊相关系数达到0.886(P<0.05),这进一步说明了指标与麻醉医师的判断具有高度一致性。结论本文设计的麻醉诱导过程性指标是评估麻醉效果稳定性的有效指标,能够应用于自助式模拟教学系统,为促进麻醉医师的培训和学习提供了新的思路和方法。ObjectiveTo investigate the design of a process indicator for anesthesia induction and its feasibility for a self-directed simulation-based teaching system,and to provide an efficient information technology-based teaching tool that enhances the quality of independent learning and training for anesthesiologists.MethodsBig data derived from electronic medical records were used for the design of the process indicator.Specifically,the design incorporated the coefficients of variations for three hemodynamic features,namely,systolic pressure,diastolic pressure,and heart rate after anesthesia induction.This approach aimed to characterize the quality of anesthesia management.A survey questionnaire was designed and administered to 23 anesthesiologists-in-charge or those with higher positions.These anesthesiologists evaluated the outcomes of anesthesia in 30 cases,thereby investigating the feasibility of the proposed indicators and potential future applications.Analysis of variance and correlation analysis were performed using SPSS 24.0 software,with a significance level set atα=0.05.ResultsBased on the range of values for the process indicator of anesthesia induction,five groups were defined:stable,relatively stable,moderately stable,relatively unstable,and unstable.There were significant intergroup differences in the anesthesiologists'ratings,with an F value of 250.66(P<0.001),indicating that the integrated coefficient of variation(ICV)effectively discriminated stability levels between groups.The designed indicator showed a significant correlation with the average ratings of the anesthesiologists,with a Pearson correlation coefficient of 0.886(P<0.05).This further indicated the great consistency between the proposed indicator and anesthesiologists'judgments.ConclusionsThe process indicator for anesthesia induction proposed in this study serves as a feasible measure for assessing the stability of anesthesia.It can be applied in a self-directed simulation-based teaching system,offering new insights and methods for promoti

关 键 词：麻醉医师 模拟教学 麻醉诱导 麻醉质量 变异系数 

分 类 号：R61[医药卫生—外科学]