目的 探索快速循环刻意练习在麻醉科住院医师电除颤技能培训中的应用效果。方法 采用试验对照方法。2019年8月,选择在华中科技大学同济医学院附属同济医院参加麻醉科住院医师规范化培训的34名学员为研究对象,采用随机数字法将其分为试验组和对照组,每组17名学员,在教师指导下限时模拟练习电除颤技能。试验组学员采用快速循环刻意练习,对照组学员采用刻意练习,练习结束时及培训结束1年后分别检测两组学员电除颤技能操作,并对两组学员进行培训满意度和独立操作电除颤信心的问卷调查。采用非参数检验或Fisher确切概率法对相关数据进行统计分析。结果 试验组学员培训后电除颤技能即刻变化量高于对照组学员[42.0(31.5,46.8)分比23.0(16.8,38.0)分],其差异具有统计学意义(P<0.01)。试验组学员培训1年后复测电除颤技能评分与对照组学员比较[62.0(59.0,65.0)分比62.5(59.0,64.0)分],其差异无统计学意义(P>0.05)。试验组学员独立完成操作的信心与对照组学员比较[80.0(61.0,97.5)分比80.0(66.5,92.5)分],其差异无统计学意义(P>0.05)。两组学员对培训方法和培训时间安排表示满意的人数均相同,分别为17人和16人。结论 快速循环刻意练习有助于提高麻醉科住院医师培训后的即刻电除颤技能成绩,学员对快速循环刻意练习与刻意练习的培训体验相当。
Objective To explore the effect of rapid cycle deliberate practice in the training of defibrillation skills of anesthesiology residents. Method This was a randomized control study in Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology. In August 2019, thirty-four residents were randomly divided into experimental group and control group with seventeen in each. The residents performed simulated defibrillation under the guidance of facilitators within a limited time. The residents in experimental group took rapid cycle deliberate practice (RCDP) protocol while control group took routine deliberate practice protocol. The performance was evaluated immediately and one year after the training, the satisfaction and confidence were investigated through online questionnaire. The collected data was analyzed with non-parametric test or Fisher's exact test. Results The scores of instant improvement of defibrillation skill in the experimental group were higher than that of the control group[42.0(31.5,46.8)vs. 23.0(16.8,38.0), P<0.01]. There was no significant difference in the skill of defibrillation [62.0(59.0,65.0)vs. 62.5(59.0,64.0),P>0.05] one year later. There were no significant difference in the confidence[80.0(61.0,97.5)vs. 80.0(66.5, 92.5),P>0.05)] between the two groups. The number of residents in the two groups who were satisfied with the training method and time arrangement was the same, 17 and 16 respectively. Conclusions The rapid cycle deliberate practice improves the training outcome of defibrillation skill immediately after the training, the training experience of rapid cyclic deliberate practice is similar to that of deliberate practice.
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