3D手术训练系统在骨科住院医师规范化培训髌骨骨折手术教学中的应用效果

doi:10.3760/cma.j.cn115259-20231213-00574

摘要/Abstract

摘要： 目的分析3D手术训练系统在骨科住院医师规范化培训中髌骨骨折手术教学中的应用效果。方法采用试验对照方法,2022年9月至2023年9月,选取在华中科技大学同济医学院附属协和医院参加骨科住院医师规范化培训的24名学员为研究对象,采用随机数表法分为试验组和对照组。试验组12名学员采用3D手术训练系统教学,对照组12名学员采用传统方式教学。通过理论考核、实践考核和满意度调查3种方式评价教学效果。采用t检验和卡方检验进行数据分析。结果理论考核中,试验组学员的理论考核总成绩[(81.42±4.68)分]高于对照组学员[(75.42±6.52)分],差异具有统计学意义(t=2.59,P=0.017)。实践考核中,试验组学员和对照组学员的复位时间[(20.25±5.26)分钟比(23.67±4.83)分钟]、透视次数[(2.75±1.06)次比(3.00±1.28)次]、术中出血量[(97.92±10.10)毫升比(100.40±7.82)毫升]比较,差异均无统计学意义(均P>0.05);试验组学员的张力带时间[(32.92±6.20)分钟]少于对照组学员[(38.42±3.63)分钟],差异具有统计学意义(t=2.65,P=0.015);试验组学员手术总时间[(86.17±11.42)分钟] 少于对照组学员[(100.20±12.22)分钟] ,差异具有统计学意义(t=2.90,P=0.008)。对照组学员完成所有考核内容后参与试验组学员的课程学习,并参加满意度调查。满意度调查结果显示,22名(91.7%)学员“愿意推荐3D手术训练系统教学方法”,20名(83.4%)学员认为“3D手术训练系统教学方法令人印象深刻”。结论应用3D手术训练系统有助于提升骨科住院医师规范化培训学员对于髌骨骨折手术教学中理论知识掌握程度,并缩短手术总时间,同时具有较高的教学满意度和教学效果。

关键词: 医师, 髌骨骨折, 3D手术训练系统, 住院医师规范化培训, 教学效果

Abstract: Objective To explore the effect of a 3D surgical training system in the teaching of patella fracture surgeries to orthopedic residents. Methods A total of 24 participants from the standardized residency training program at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from September 2022 to September 2023, were selected and assigned into two groups using a random number table method, with 12 in the experimental group receiving the course using 3D surgical training system and 12 in the control group receiving traditional instruction. The teaching effectiveness was evaluated using knowledge examination, skills assessment, and satisfaction surveys. T-tests and chi-square tests were used for data analysis. Results In knowledge examination, total scores for the experimental group were (81.42±4.68) and (75.42±6.52) for the control group, with a statistically significant difference (t=2.59,P=0.017). In skills assessment, there were no significant differences between the experimental group and the control group interms of the duration of fracture reduction was (20.25±5.26) minutes for experimental group and (23.67±4.83) minutes for control group , the number of fluoroscopies use was (2.75±1.06) times for experimental group and (3.00±1.28) times for control group, and intraoperative blood loss was (97.92±10.10) ml for experimental group and (100.40±7.82) ml for control group (P>0.05). The time taken for the tension band was (32.92±6.20) minutes for the experimental group and (38.42±3.63) minutes for the control group, a statistically significant difference (t=2.65, P=0.015). The overall surgical duration was (86.17±11.42) minutes for the experimental group and (100.20±12.22) minutes for the control group, with a statistically significant difference (t=2.90, P=0.008).After completing all assessment components, the control group participants joined the experimental group′s course and participated in a satisfaction survey.satisfaction survey showed that 22(91.7%) were willing to recommend the teaching method, and 20(83.4%) found the teaching method impressive. Conclusions The application of the 3D surgical training system helped improve the theoretical knowledge acquisition of orthopedic residents in patella fracture surgery training and reduced the overall surgical time, and achieved high levels of teaching satisfaction and effectiveness.

Key words: Physicians, Patella fractures, 3D surgical training system, Standardized residency training, Teaching effectiveness

中图分类号:

薛明迪, 孙玉东, 王泓霖, 周弘, 杨佳铭, 孙伟, 何书明, 王毅, 谢卯, 叶哲伟. 3D手术训练系统在骨科住院医师规范化培训髌骨骨折手术教学中的应用效果[J]. 中华医学教育杂志, 2025, 45(2): 135-140.

Xue Mingdi, Sun Yudong, Wang Honglin, Zhou Hong, Yang Jiaming, Sun Wei, He Shuming, Wang Yi, Xie Mao, Ye Zhewei. Effect of a 3D surgical training system in patella fracture surgery teaching for orthopedic residents[J]. Chinese Journal of Medical Education, 2025, 45(2): 135-140.

参考文献

[1] Dorafshar AH, Jazayeri HE. Discussion: is digital animation superior to text resources for facial transplantation education? a randomized controlled trial[J]. Plast Reconstr Surg, 2021,148(2):427-428. DOI: 10.1097/PRS.0000000000008167.
[2]郗洪庆,张珂诚,吴晓松,等. TBL联合PBL在普通外科腹腔镜手术教学中的应用[J].中华医学教育探索杂志,2017, 16(9):931-934. DOI: 10.3760/cma.j.issn.2095-1485.2017.09.017.
[3]DeCamp M, Lehmann LS, Jaeel P, et al. Ethical obligations regarding short-term global health clinical experiences: an American College of Physicians position paper[J]. Ann Intern Med, 2018,168(9):651-657. DOI: 10.7326/M17-3361.
[4]Pape-Koehler C, Immenroth M, Sauerland S, et al. Multimedia-based training on internet platforms improves surgical performance: a randomized controlled trial[J]. Surg Endosc, 2013,27(5):1737-1747. DOI: 10.1007/s00464-012-2672-y.
[5]Ahmet A, Gamze K, Rustem M, et al. Is video-based education an effective method in surgical education? a systematic review[J]. J Surg Educ, 2018, 75(5): 1150-1158. DOI: 10.1016/j.jsurg.2018.01.014
[6]Salem J, Borgmann H, MacNeily A, et al. New media for educating urology residents: an interview study in Canada and Germany[J]. J Surg Educ. 2017,74(3):495-502. DOI: 10.1016/j.jsurg.2016.11.009.
[7]Youssef SC, Aydin A, Canning A, et al. Learning surgical skills through video-based education: a systematic review[J]. Surg Innov. 2023,30(2):220-238. DOI:10.1177/15533506221120146.
[8]Marsh HW. SEEQ: a reliable, valid, and useful instrument for collecting students′ evaluations of university teaching[J]. Brit J Educ Psychol, 1982, 52(1): 77-95. DOI:10.1111/j.2044-8279.1982.tb02505.x.
[9]Benlice C, Elcircevi A, Kutlu B, et al. Comparison of textbook versus three-dimensional animation versus cadaveric training videos in teaching laparoscopic rectal surgery: a prospective randomized trial[JColorectal Dis]. Colorectal Dis, 2022, 24(8):1007-1014. DOI: 10.1111/codi.16119.
[10]Prinz A, Bolz M, Findl O. Advantage of three dimensional animated teaching over traditional surgical videos for teaching ophthalmic surgery: a randomised study[J]. Br J Ophthalmol, 2005,89(11):1495-1499. DOI: 10.1136/bjo.2005.075077.
[11]Fidanza A, Caggiari G, Di Petrillo F, et al. Three-dimensional printed models can reduce costs and surgical time for complex proximal humeral fractures: preoperative planning, patient satisfaction, and improved resident skills[J]. J Orthop Traumatol. 2024,25(11):1-10. DOI:10.1186/s10195-024-00754-6.
[12]Bogomolova K, van Merriënboer J, Sluimers JE, et al. The effect of a three-dimensional instructional video on performance of a spatially complex procedure in surgical residents in relation to their visual-spatial abilities[J]. Am J Surg, 2021,222(4):739-745. DOI: 10.1016/j.amjsurg.2021.01.033.
[13]Yang Y, Li LY, Sang LW, et al. An observation of a resident-as-teacher combined with tutor guided hysteroscopy teaching program for standardized residency training in obstetrics and gynecology[J]. J Healthc Eng, 2020, 2020(6):1-10. DOI: 10.1155/2020/8855099.
[14]Gray M, Downer T, Hartz D, et al. The impact of three-dimensional visualisation on midwifery student learning, compared with traditional education for teaching the third stage of labour: A pilot randomised controlled trial[J]. Nurs Educ Today, 2022, 108:105184. DOI: 10.1016/j.nedt.2021.105184.
[15]Wolfe EM, Alfonso AR, Diep GK, et al. Is digital animation superior to text resources for facial transplantation education? A randomized controlled trial[J]. Plast Reconstr Surg, 2021, 148(2): 419-426. DOI: 10.1097/PRS.0000000000008166.
[16]Thompson JW, Thompson EL, Sanghrajka AP. The future of orthopaedic surgical education: where do we go now?[J]. Surg, 2022,20(4):86-94. DOI:10.1016/j.surge.2021.05.005.