手术是眼科住院医师规范化培训的重点和难点,但目前却缺乏标准化培训和评价方法。本研究通过文献研究和专家咨询设计了眼科住院医师规范化培训中斜视手术标准化培训与评价系统,选用2种斜视基础术式分别标准化为7个步骤,分4个阶段进行操作培训,采用阶段考核与终末考核相结合的方式评价学员对培训内容的掌握程度。通过考核满意度调查、参培与未参培学员结业后专业从事情况评价系统应用效果。2021年3月至5月将系统应用于郑州大学第一附属医院眼科2019级36名住院医师规范化培训学员,学员的培训整体满意度为83.3%(30/36),88.9%(32/36)的学员认为通过培训,斜视手术较其他亚专业手术掌握得更好。结业后,33.3%(12/36)的学员能在工作中完成所培训的两种手术术式,高于2018级未参培学员的3.8%(1/26);44.4%(16/36)的学员愿意或正在进行斜视与小儿眼科专业培训,高于2018级未参培学员的3.8%(1/26)。可见,斜视手术标准化培训与评价系统有助于学员完成斜视手术的标准化培训,促进其掌握斜视手术基础术式和开展相关专业工作。
Surgical skill is vital and one of the difficulties during the standardized training of ophthalmology residents. But there exists no training standards nor evaluating methods. This study aims to establish a standardized training system for strabismus surgery, and to improve the training quality of strabismus surgery during the standardized training of residents through literature research and expert consultation. Two fundamental surgical practices are standardized into 7 steps and 4 phases throughout the operational training. The levels of trainee are evaluated during each phase and at the final stage. The program application effect is evaluated through test satisfaction investigation between trainees and the untrained. A total of 36 students from grade 2019 in the Ophthalmology Department from the First Affiliated Hospital of Zhengzhou University were selected as the training group. The overall satisfaction rate of the trainees was 83.3%(30/36). It was considered a higher level of strabismus operational procedures than other sub-operations after training by 88.9% (32/36) of the trainees. At the accomplishment of training, 33.3% (12/36) of the trainees were able to complete 2 operation methods from the training, which is higher than the 3.8% (1/26) of the untrained students from grade 2018. There was 44.4% (16/36) of the trainees who showed intentions for or already under the specialized training of strabismus and pediatric ophthalmology, which was higher than the 3.8% (1/26) of the untrained students from grade 2018. The establishment of the strabismus standardized surgery evaluation system can provide strong support for the standardized training of high-level ophthalmology residents and helps improving their proficiency of the basic methods of strabismus surgery, as well as other related practices.
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