肝移植麻醉临床模拟教学工具(ALTs)的使用探索  

Exploration of Clinical Simulation Teaching Tools (ALTs) for Anesthesia in Liver Transplantation

作　　者：储琳 张升宁[1,2,3] 董权[1,2,3] 李兵 杜伟忠[1,2,3] 胡宗强[1,2,3] 

机构地区：[1]昆明医科大学附属甘美医院,云南 昆明 [2]昆明市第一人民医院,云南 昆明 [3]云南省器官移植临床医学中心,云南 昆明

出　　处：《教育进展》2021年第3期931-937,共7页Advances in Education

摘　　要：肝移植手术麻醉的内容包括前评估、各种监测管路的放置、诱导期及术中各个阶段的麻醉处理以及循环容量监测,其合理性直接影响着患者术后的成活率和并发症的发生率。上述各方面对麻醉专业住院规范化培训的住院医师或研究生的教学都具挑战性,为此我们开发了一套ALTs (Anesthesia for liver transplantation simulation)的PBL (problem-based learning)结合模拟课程,该课程为以肝移植麻醉过程中相关问题为导向,以人体模型为基础的模拟教学场景。通过模拟前后的课程小测验,以及在为期一个月的ALTs轮转学习期结束时进行的调查,对测试结果进行了衡量。24名住院医师完成了ALTs模拟课程,模拟前测试的平均得分为70.42 ±10.71,模拟后测试的平均得分为82.63 ±6.9 (p 【0.05),说明培训前后成绩差异对比有统计学意义。此外,调查得分显示,该课程改善了对患者术前评估的效果、提高了与患者知情同意的沟通技巧,术前相关设备药物的准备、应对术中麻醉的管理、处理突发事件的信心、特殊技能的操作都有了大幅的提升。The content of anesthesia for liver transplantation includes preassessment, placement of various monitoring tubes, anesthesia treatment during the induction period and various stages of the operation, and circulatory volume monitoring. Its rationality directly affects the survival rate of patients and the occurrence of complications after surgery. The abovementioned aspects are challenging for the teaching of residents or graduate students with standard training in anesthesia specialty. For this reason, we have developed a set of ALTs (Anesthesia for liver transplantation simulation) PBL (problem-based learning) combined simulation courses, which are related to the problems in the anesthesia process of liver transplantation. It is a simulated teaching scene based on human body model. The test results were measured through the course quizzes before and after the simulation and the survey conducted at the end of the one-month ALTs learning period. Twenty-four residents completed the ALTs simulation course. The average score of the pre-simulation test was 70.42 ±10.71, and the average score of the post-simulation test was 82.63 ±6.9 (p

关 键 词：肝移植麻醉 模拟教学 

分 类 号：R61[医药卫生—外科学]