目的 探讨虚拟现实腰椎穿刺培训系统在八年制医学生儿科腰椎穿刺操作技能培训中的应用效果。方法 本研究采用试验对照方法。2018年5月至2019年4月,选择北京大学医学部2015级八年制临床医学专业33名学生为研究对象,随机将其分为试验组16人,对照组17人。试验组学生采用虚拟现实腰椎穿刺培训系统进行培训,对照组学生采用传统橡胶模型进行培训。教学结束后,对两组学生进行腰椎穿刺操作技能及相关理论知识考核,并采用座谈和问卷调查方法了解试验组学生对虚拟现实腰椎穿刺培训系统的认可程度。结果 试验组学生操作技能成绩优于对照组[(73.4±3.6)分比(69.6±3.9)分],其差异具有统计学意义(t=2.804,P＜0.01);试验组学生与对照组学生沟通技能评分为[(8.3±0.6)分比(8.4±0.6)分,t=-0.042,P=0.967],理论知识成绩为[(8.4±0.6)分比(8.5±0.4)分,t=-0.191,P=0.850)],其差异均无统计学意义。绝大部分试验组学生对应用虚拟现实腰椎穿刺培训系统进行技能培训予以肯定。结论 虚拟现实腰椎穿刺培训系统在八年制医学生儿科技能培训中起到了积极的作用,可以提高八年制医学生的腰椎穿刺操作技能。
Objective To study the effects of virtual reality in pediatric lumbar puncture clinical skill training of medical students. Methods This study uses an experimental control method. A randomized controlled study was conducted with 33 eight-year program students of the Peking University Health Science Center(16 in experimental group and 17 in the control group) from May 2018 to April 2019. The students in experimental group were taught by the virtual reality lumbar puncture model and the those in the control group were taught by traditional rubber lumbar puncture model. All the students were evaluated by clinical skill and theoretical knowledge tests after training. The degree of recognition of virtual reality lumbar puncture training system was investigated via symposium and questionnaire survey. Results The operating skills of the students in the experimental group were better than those in the control group [(73.4±3.6) vs (69.6±3.9),t=2.804, P＜0.01]. There was no significant difference in the communication skills[(8.3±0.6) vs (8.4±0.6),t=-0.042, P=0.967)] and theoretical knowledge [(8.4±0.6) vs (8.5±0.4),t=-0.191, P=0.850)] between the two groups. The virtual reality lumbar puncture training system was accepted by most of the students in experimental group. Conclusions The virtual reality plays an active role in lumbar puncture skill training of eight-year medical students. It can improve the skills of lumbar puncture
[1] Walsh CM. Training and assessment in pediatric endoscopy[J]. Gastrointest Endosc Clin N Am, 2016,26(1):13-33. DOI: 10.1016/j.giec.2015.08.002.
[2] Arafeh JMR. Update: simulation-based training[J]. J Perinat Neonatal Nurs, 2017, 31(4): 286-289.DOI: 10.1097/JPN.0000000000000288.
[3] Gilfoyle E, Koot DA, Annear JC, et al. Improved clinical performance and teamwork of pediatric interprofessional resuscitation teams with a simulation-based educational intervention[J]. Pediatr Crit Care Med, 2017,18(2):e62-e69. DOI: 10.1097/PCC.0000000000001025.
[4] Dudas RA, Colbert-Getz JM, Balighian E, et al. Evaluation of a simulation-based pediatric clinical skills curriculum for medical students[J]. Simul Healthc, 2014,9(1):21-32. DOI: 10.1097/SIH.0b013e3182a89154.
[5] Lopreiato JO, Sawyer T. Simulation-based medical education in pediatrics[J]. Acad Pediatr, 2015,15(2):134-142. DOI: 10.1016/j.acap.2014.10.010.
[6] Ross J, Rebella G, Westergaard M, et al. Simulation training to maintain neonatal resuscitation and pediatric sedation skills for emergency medicine faculty[J]. WMJ, 2016, 115(4): 180-184.
[7] 丁晶, 曾超美.情景模拟联合行为回放式教学方法在八年制临床医学专业学生儿科学临床技能培训中的应用[J].中华医学教育杂志,2015,35(3):383-385. DOI:10.3760/cma.j.issn.1673-677X.2015.03.021.
[8] Izard SG, Juanes JA, García Peñalvo FJ, et al. Virtual reality as an educational and training tool for medicine[J]. J Med Syst, 2018, 42(3): 50.DOI: 10.1007/s10916-018-0900-2.
[9] Wilson AS, O'Connor J, Taylor L, et al. A 3D virtual reality ophthalmoscopy trainer[J]. Clin Teach, 2017, 14(6): 427-431.DOI: 10.1111/tct.12646.
[10] Wong DT, Mehta A, Singh KP, et al. The effect of virtual reality bronchoscopy simulator training on performance of bronchoscopic-guided intubation in patients: a randomized controlled trial[J]. Eur J Anaesthesiol, 2019, 36(3): 227-233.DOI: 10.1097/EJA.0000000000000890.
[11] Ramlogan R, Niazi AU, Jin Ry, et al. A virtual reality simulation model of spinal ultrasound: role in teaching spinal sonoanatomy[J]. Reg Anesth Pain Med, 2017, 42(2): 217-222.DOI: 10.1097/AAP.0000000000000537.
[12] 石巧, 侯建霞. 虚拟现实技术在口腔诊疗操作培训中的应用[J]. 国际口腔医学杂志, 2015, 42(1): 69-74. DOI:10.7518/gjkq.2015.01.018.
