中华医学教育杂志

中华医学教育杂志 ›› 2021, Vol. 41 ›› Issue (7): 601-605.DOI: 10.3760/cma.j.cn115259-20210114-00070

• 教育技术 • 上一篇    下一篇

模拟器在住院医师产科超声检查技能评估中的应用

赵永锋1, 唐晓鸿2, 彭洪1, 刘稳刚1, 李林璐1, 袁乐2, 周平1   

  1. 1中南大学湘雅三医院超声科,长沙 410013;
    2中南大学湘雅三医院临床技能训练中心,长沙 410013
  • 收稿日期:2021-01-14 出版日期:2021-07-01 发布日期:2021-06-29
  • 通讯作者: 周平, Email: zhouping1000@hotmail.com, 电话: 0731-88618403
  • 基金资助:
    国家医学考试中心实证研究项目(20190066)

Application of ultrasound simulator in assessing residents' skill of obstetric ultrasound scanning

Zhao Yongfeng1, Tang Xiaohong2, Peng Hong1, Liu Wengang1, Li Linlu1, Yuan Le2, Zhou Ping1   

  1. 1Department of Ultrasound, The Third Xiangya Hospital of Central South University, Changsha 410013, China;
    2Clinical Skill Center, The Third Xiangya Hospital of Central South University, Changsha 410013, China
  • Received:2021-01-14 Online:2021-07-01 Published:2021-06-29
  • Contact: Zhou Ping, Email: zhouping1000@hotmail.com, Tel: 0086-731-88618403
  • Supported by:
    National Medical Examinations Centre Empirical Research Project (20190066)

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摘要： 目的 探讨采用模拟器考核评估住院医师Ⅲ级产科超声检查技能的可行性。方法 本研究采用试验对照方法。2019年9月,选取中南大学湘雅三医院超声科30名住院医师作为研究对象,在志愿者孕妇和模拟器上各进行2次Ⅲ级产科超声检查技能考核。比较志愿者孕妇考核与模拟器考核的成绩,分析志愿者孕妇考核与模拟器考核成绩的相关性,观察考核的难度与区分度,通过组内相关系数(intraclass correlation coefficient,ICC)评估评分者之间信度与重测信度。结果 考生的2次志愿者孕妇考核成绩分别为P1=(50.39±9.71)分,P2=(53.39±10.63)分,2次模拟器考核成绩分别为S1=(54.41±9.52)分,S2=(57.51±9.76)分,S1高于P1,S2高于P2,其差异均具有统计学意义(均P<0.01)。模拟器考核与志愿者孕妇考核成绩呈正相关(r=0.784,P＜0.01)。模拟器考核与志愿者孕妇考核的难度为:PS1=0.54,PS2=0.58,PP1=0.50,PP2=0.53,区分度为DS1=0.67,DS2=0.65,DP1=0.70,DP2=0.72。模拟器考核与志愿者孕妇考核均具有良好的评分者之间信度(模拟器考核ICC=0.838,P＜0.01;志愿者孕妇考核ICC=0.762,P＜0.01)和重测信度(模拟器考核ICC=0.878,P＜0.01;志愿者孕妇考核ICC=0.760,P＜0.01)。结论 模拟器考核与志愿者孕妇考核成绩虽然存在差异,但二者具有高度的相关性,且模拟器考核难度适中、区分度高、信度良好,有望作为传统志愿者孕妇考核方式的替代方案评估住院医师的Ⅲ级产科超声检查技能。

关键词: 模拟器, 产科超声, 技能考核, 住院医师

Abstract: Objective To explore the feasibility of introducing ultrasound simulator test in assessing residents' obstetric ultrasound scanning skills. Methods An experimental comparative method was used in this study. In September 2019, 30 residents in the Department of Ultrasound of the Third Xiangya Hospital of Central South University were included in the study as examinees. They completed two runs of obstetric ultrasound scan skill assessments on volunteer pregnant women and on ultrasound simulator (P1, S1, S2, P2), respectively. The scores in volunteer pregnant women tests and simulator tests were compared, and the correlation between scores recorded in volunteer pregnant women tests and simulator tests was analyzed. The difficulty and differentiation degrees of tests were observed. The inter-rater reliability and test-retest reliability were evaluated by intraclass correlation coefficient (ICC). Results Scores from volunteer pregnant women test were P1= (50.39±9.71), P2= (53.39±10.63) and the scores from simulator test were S1= (54.41±9.52), S2= (57.51±9.76). Scores in S1 were higher than that of P1, and scores in S2 were higher than that of P2 (P<0.01). A positive correlation between the two sets of scores was found (r=0.784, P<0.01). The difficulty degrees of simulator test and volunteer pregnant women test were PS1=0.54, PS2=0.58, PP1=0.50, PP2=0.53 respectively and the differentiation degrees of simulator test and volunteer pregnant women test were DS1=0.67, DS2=0.65, DP1=0.70, DP2=0.72 respectively. The inter-rater reliability of simulator test and volunteer pregnant women test was high (simulator test: ICC=0.838, P<0.01;volunteer pregnant women test: ICC=0.762, P<0.01). The test-retest reliability of simulator test and volunteer pregnant women test was high (simulator test: ICC=0.878, P<0.01;volunteer pregnant women test: ICC=0.760, P<0.01). Conclusions Although there are differences between scores recorded in simulator test and volunteer pregnant women test, the simulator test is highly correlated with volunteer pregnant women test. The difficulty degree of simulator test is medium, the differentiation degree is high, and the reliability is high. Simulator test is expected to be an alternative to the test with volunteer pregnant women in assessing residents' skill of obstetric ultrasound scanning.

Key words: Simulator, Obstetric ultrasound scanning, Skill assessment, Residents

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