目的 探讨模块化模拟教学方法在运动医学肩关节镜手术培训中的应用效果。方法 选取2018年4月至2019年10月在北京强生培训中心参加肩关节镜手术模拟培训的111名进修医师作为研究对象,分析比较其培训成绩和问卷调查结果。采用非参数Mann-Whitney U检验、t检验对所得数据进行分析。结果 肩关节镜模拟技术培训前后进修医师抓持传递操作用时[(202.92±27.86)秒比(123.44±18.93)秒],缝合打结操作用时[(333.77±24.36)秒比(183.92±14.19)秒]比较,其差异均具有统计学意义(均P＜0.05)。培训前后,三甲医院进修医师和非三甲医院进修医师抓持传递用时时间差为[43.5(9.0,60.5)秒比40.0(19.5,147.0)秒]、缝合打结用时时间差为[85.0(60.0,180.0)秒比120.0(60.0,260.0)秒],其差异均无统计学意义(均P＞0.05)。培训前后,骨科进修医师和运动医学科进修医师抓持传递用时时间差为[60.0(23.0,90.0)秒比20.0(6.0,60.0)秒]、差异具有统计学意义(P＜0.05),缝合打结用时时间差为[80.0(52.0,172.3)秒比90.0(60.0,275.0)秒],差异无统计学意义(P＞0.05)。进修医师对模拟培训的满意度为100.0%(111/111)。结论 采用模块化模拟教学方法进行肩关节镜手术培训后,不同级别和不同专业的进修医师的基本手术技术均得到了提升。这种培训方式适用于不同级别医院的进修医师,也适用于骨科或运动医学科专业的进修医师。

Objective To evaluate the effect of modularized simulation-based training mode in arthroscopic surgery. Methods Totally 111 refresher physicians who participated in the training of shoulder arthroscopic surgery simulation from April 2018 to October 2019 in Beijing Johnson & Johnson Training Center were recruited. All the participants conducted on-site training record and questionnaire survey. Non-parametric Mann-Whitney U test and T test were used to analyze the obtained data. Results On completion of the training, participants showed significant improvement in the time of grasping and transferring [(202.92±27.86) seconds vs. (123.44±18.93) seconds], for the time of suturing and knotting, the training also witnessed significant decrease [(333.77±24.36) seconds vs. (183.92±14.19) seconds] (all P<0.05). After the training, the times of grasping and transferring shortened [43.5(9.0,60.5)] seconds in tertiary hospital group and [40.0(19.5,147.0)] seconds in non-tertiary hospital group, while the time of suturing and knotting shortened [85.0(60.0,180.0)] seconds in tertiary hospital group and [120.0(60.0,260.0)] seconds in non-tertiary hospital group. There was no significant difference between the refresher physicians come from the tertiary hospitals and non-tertiary hospitals groups regarding the shortened time (all P>0.05). The orthopedics group improve [60.0(23.0,90.0)] seconds in the time of grasping and transferring and the sports medicine group improve [20.0(6.0,60.0)] seconds (P<0.05). For the time of suturing and knotting, [80.0(52.0,172.3)] seconds and [90.0(60.0,275.0)] seconds were improved respectively. The difference was not statistically significant (P>0.05). The refresher physicians satisfaction of the simulation training is 100.0% (111/111). Conclusions The basic surgical skills of refresher physicians from both orthopedics and sports medicine after the training of modular arthroscopic surgery simulation are significantly improved. The method is suitable for refresher physicians from hospitals of different levels and for both orthopedics and sports medicine.