目的 评价模拟教学在八年制临床医学专业学生外科手术基本技能操作训练中应用的可行性及其效果。方法 选取北京大学2012级八年制临床医学专业46名学生为研究对象,将其随机分为实验组和对照组,每组23人。对照组接受传统的外科手术基本技能操作训练,实验组接受模拟教学方法训练。两组训练时间均为3周。分别于训练结束时、训练结束1年后,以客观结构化技能评价方式对两组学生进行考核评分。第二次考核结束后对实验组学生进行问卷调查。结果 训练结束时考核,实验组学生的外科手术基本技能操作考核成绩明显高于对照组,差异具有统计学意义(t=9.194,P=0.001);训练结束1年后再次进行考核,实验组学生的外科手术基本技能掌握牢固程度也明显高于对照组,差异具有统计学意义(t =14.140,P=0.001)。问卷调查结果表明,大部分实验组学生对模拟教学方法给予肯定。结论 模拟教学是培养医学生外科手术基本技能操作的有效方法,有利于加强学生对外科手术基本技能操作掌握的熟练程度和牢固程度,值得推广。
Objective To evaluate the effect and feasibility of simulation teaching on the acquisition and retention of basic surgical clinic skills for eight-year medical program.Methods 46 clinical medical students of eight-year medical program in 2012 grade in Peking University Third Hospital were randomized to a simulation training (experimental group) or a traditional teaching (control group) for surgical skill training curriculum during a period of 3 weeks. Students were tested with objective structured assessment of technical skills (OSATS) scoring system after training and 1 year later.Results 46 students completed all models training and post-training assessments. OSATS scores were higher in experimental group compared with control group (t=9.194, P=0.001). After 1 year, this effect persisted with OSATS scores still being significantly higher in experimental group (t=14.140, P=0.001). The simulation teaching method was approved by most of students through the questionnaire survey.Conclusions Simulation teaching improves technical efficiency. Retesting can further evaluate advantages of simulation teaching.
[1] Zhao Z, Niu P, Ji X, et al.State of simulation in healthcare education: An initial survery in Beijing [J]. JSLS, 2017,21(1):e2016.00090. DOI: 10.4293/JSLS.2016.00090.
[2] 梁书静,姜冠潮,张斯琴,等.八年制临床医学专业学生模拟教学效果探析[J]. 中华医学教育杂志,2016,36(4):555-558. DOI:10.3760/cma.j.issn.1673-677X.2016.04.019.
Liang SJ, Jiang GC, Zhang SQ, et al.Analysis and discussion on the effect of SBME for the eight-year clinical medical students[J]. Chin J Med Edu,2016,36(4):555-558. DOI:10.3760/cma.j.issn.1673-677X.2016.04.019.
[3] Tansley G, Bailey JG, Gu Y, et al.Efficacy of surgical simulation training in low-income country [J]. World J Surg, 2016,40(11):2643-2649. DOI: 10.1007/s00268-016-3573-3.
[4] Willis RE, Van Sickle KR.Current status of simulation-based training in graduate medical education [J]. Surg Clin North Am, 2015,95(4):767-779. DOI: 10.1016/j.suc.2015.04.009.
[5] 刘威,王洪羽,万晓明,等.模拟教学在临床技能教学中的应用[J]. 吉林医药学院学报.2015,36(4):313-314. DOI:10.13845/j.cnki.issn1673-2995.2015.04.033.
[6] Fonseca AL, Evans LV, Gusberg RJ.Open surgical simulation in residency training: A review of its status and a case for its incorporation [J]. J Surg Educ, 2013,70(1):129-137. DOI:10.1016/j.jsurg.2012.08.007.
[7] Ericsson KA.Deliberate practice and the acquisition and maintenance of expert performance in medicine and related domains [J]. Acad Med, 2004,79(10):S70-S81.
