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| 模型教学法在经支气管镜高频电圈套术培训中的应用 |
| 钱堃1\2,黄海东1*,王琴1,陈长明1,宁允叶1,白冲1,李强1 |
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(1. 第二军医大学长海医院呼吸与危重症医学科, 上海 200433;
2. 安徽医科大学第四附属医院呼吸内科, 合肥 230001
*通信作者) |
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| 摘要: |
| 目的 探讨基于一种支气管镜诊疗模型的综合教学法在经支气管镜高频电圈套术培训中的作用。方法 采用前瞻性自身对照研究，选择20名在第二军医大学长海医院呼吸内镜中心受训的学员作为培训对象，由2名长海医院呼吸内镜专家指导，通过理论知识辅导和模型训练的综合教学法开展经支气管镜高频电圈套操作培训。比较培训前后学员在高频电圈套操作的准确性、流畅度、操作耗时、病灶切除率等方面的差异，并针对培训效果进行问卷调查。结果 20名学员均顺利完成操作培训。与培训前相比，培训后学员经支气管镜高频电圈套切除目标病灶的操作准确性评分由5.73±1.37提高到8.50±0.81，差异有统计学意义（P<0.01）；操作流畅度评分由5.20±1.61提高到8.27±1.00，差异有统计学意义（P<0.01）；操作总耗时由（214.9±112.6）s缩短到（88.1±18.2）s，差异有统计学意义（P=0.01）；一次性病灶切除率由（60.0±16.3）%提高到（76.0±12.6）%，差异有统计学意义（P=0.05）。对学员的问卷调查结果显示，模型教学法在操作可重复性、仿真度、安全性，以及增加操作稳定性、提高培训效率方面均具有一定优势。结论 采用基于支气管镜诊疗模型的综合教学法开展经支气管镜高频电圈套术的培训，教学效果显著，值得推广。 |
| 关键词: 支气管镜 教育模型 培训 高频电圈套术 |
| DOI：10.16781/j.0258-879x.2016.12.1528 |
| 投稿时间：2016-08-02修订日期：2016-10-16 |
| 基金项目:上海市卫生局局级课题（20124166），长海医院首批医疗新技术培育项目（NT201506）. |
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| Application of a simulator-based teaching method in training of bronchoscopic high-frequency electrocautery snare technique |
| QIAN Kun1\2,HUANG Hai-dong1*,WANG Qin1,CHEN Chang-ming1,NING Yun-ye1,BAI Chong1,LI Qiang1 |
(1. Department of Respiratory and Critical Care Medicine, Changhai Hospital, Second Military Medical University, Shanghai 200433, China;
2. Department of Respiratory, the Fourth Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui, China
* Corresponding author) |
| Abstract: |
| Objective To explore the role of a comprehensive teaching method based on a diagnosis-and-treatment simulator for bronchoscopic procedure in the training of high-frequency electrocautery using snare. Methods A prospective self-control study including 20 trainees from the Bronchoscopic Center of Changhai Hospital was designed to evaluate the training outcome of bronchoscopic high-frequency electrocautery snare technique. During the training course, theoretical knowledge teaching was followed by simulator-based practice under the guidance of respiratory endoscopic exports from Changhai Hospital. We recorded and analyzed the procedure accuracy and fluency,operation time, and target tissue excision rate of each trainee before and after the training project. The appraisal of the training effect for each trainee in this study was conducted by questionnaire survey. Results All the 20 trainees successfully completed the whole training project. Compared with the data before the training, the procedure accuracy of excising the target tissue by snare after the training was significantly increased from 5.73±1.37 to 8.50±0.81 (P<0.01); the fluency of operating snare was significantly improved from 5.20±1.61 to 8.27±1.00 (P<0.01); the total operation time-consuming was significantly shortened from (214.9±112.6)s to (88.1±18.2) s (P=0.01); and the target tissue excision rate was increased significantly from (60.0±16.3)% to (76.0±12.6)% (P=0.05). The questionnaire survey showed that all the trainees benefited from the comprehensive simulator-based teaching method. The advantages of this teaching method included repeatability, high simulation degree, safety, operational stability and improved training efficiency. Conclusion The simulator-based comprehensive teaching method has a distinct teaching outcome in bronchoscopic electrocautery snare technique training, and is worth promoting in bronchoscopic training. |
| Key words: bronchoscope educational models training high-frequency electrocautery snare |
