目的 本研究旨在比较计算机模拟软件与依赖全尺度模拟人的情景模拟在天津医科大学总医院麻醉新入科医生高级心脏生命支持(advanced cardiovascular life support,ACLS)培训中的效果。方法 本研究采用试验对照方法,选取2020年10月至2021年12月新入科正在进行规培的62名住院医师和五年级麻醉学专业本科生为研究对象,按照学员不同身份属性持续随机分为计算机软件模拟组(C组)、全尺度模拟人情景模拟组(M组)和计算机模拟联合组(SM组)。以培训前(T0)、培训后即刻(T1)为时间点,对比学员技术能力与非技术能力评分,结合培训结束时对学员的问卷调查结果评估对培养模式的满意度。采用描述性统计、t检验、方差分析和χ2检验进行数据分析。结果 技术能力评价结果显示,C组、M组、SM组学员T1技术能力评分,均高于T0[(21.05±3.39)比(14.24±4.31)分、(21.33±2.93)比(15.14±3.66)分和(20.33±3.62)比(15.06±3.63)分],其差异均具有统计学意义(均P<0.05),但三组学员同一时间点技术能力评分差异无统计学意义(P>0.05)。非技术能力测试结果显示,三组学员在T1分别为(10.67±2.33)、(12.38±2.16)和(12.20±2.14)分,M组和SM组学员评分高于C组学员(P<0.05)。调查结果显示,在“该模式能够激发我的兴趣”方面,M组和SM组学员的满意度均高于C组学员(P<0.05)。结论 计算机模拟和全尺度模拟人情景模拟均能有效提升培训学员的ACLS技术与非技术能力,而在非技术能力提升上情景模拟更具优势。因此,计算机模拟可以作为ACLS培训中情景模拟的有效补充工具。
Objective To compare the effectiveness of computer-based simulation and full-scale mannequin-based scenario simulation in advanced cardiac life support (ACLS) training for newly enrolled anesthesia trainees at Tianjin Medical University General Hospital. Methods From October 2020 to December 2021, a prospective randomized controlled design was used to randomly divide 62 newly admitted residents and interns into computer software simulation group (group C), full-scale simulator scenario simulation group (group M) and computer simulation group (SM group). The baseline test was performed before training (T0), and the immediate test was conducted after training (T1). The technical and non-technical competency scores of the participants before and after training were compared, and a questionnaire survey was used to evaluate their satisfaction with the training model at T1. Descriptive statistics, t-tests, analysis of variance, and χ2 tests were used for data analysis. Results In terms of technical competency, the technical competency scores of Groups C, M and SM at T1 were significantly higher than those at T0 [(21.05±3.39) vs. (14.24±4.31), (21.33±2.93) vs. (15.14±3.66), and (20.33±3.62) vs. (15.06±3.63), respectively; all P<0.05], with no significant differences among groups at the same time point (P>0.05). For non-technical competency, the scores of the three groups at T1 were (10.67±2.33), (12.38±2.16) and (12.20±2.14) respectively, with the scores of Group M and Group SM higher than that of Group C (P<0.05). In the survey, the satisfaction of Groups M and SM with the statement ″this training mode can stimulate my interest″ was significantly higher than that of Group C (P<0.05). Conclusions Computer simulation and full-scale simulator scenario simulation can effectively improve the ACLS technical and non-technical abilities of the trainees, while scenario simulation has more advantages in non-technical ability improvement. Therefore, computer simulation can be used as an effective complementary tool for scenario simulation in ACLS training.
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