扶贫超声乳化白内障吸出联合人工晶状体植入术的新型教学模式探讨

Evaluation of the effect of novel model for teaching of charity cataract phacoemulcification

目的：探讨分步式新型教学模式提高扶贫超声乳化白内障吸出术的教学质量。方法将超声乳化白内障吸除术的整个手术过程划分为4个阶段，15个步骤，对基层眼科医生采用循序渐进、层层深入的教学方法进行手术带教。13名地方眼科医生被纳入研究，其中6名进入传统教学组，7名进入新型教学组，观察并比较两组的教学效果。两组间引发严重并发症的学员比例和发生影响视力预后并发症的患者比例比较，采用卡方检验，符合正态分布的定量资料比较采用独立样本t检验。结果传统教学组中，有2/6名学员在12周的教学时间内独立完成超声乳化白内障吸除术；新型教学组中，则有6/7名学员独立完成此手术。传统教学组中，高达4/6的学员在学习期间引发严重的手术并发症；新型教学组中，未见引发严重手术并发症的学员，两组比较差异有统计学意义（χ2＝0．02，P ＝0．02）。传统教学组中，有2～23（10．8±7．5）例患者发生影响视力预后的并发症；在新型教学组中，则为5（2．3±1．8）例，两组比较差异有统计学意义（t＝2．72，P＝0．04）。结论分步式新型扶贫超声乳化白内障吸出术教学模式可获得良好的教学效果。

Obejc tive To study the application of the step-by-step teaching method to improve the quality of teaching of charity cataract phacoemulcification.Methods The whole operation process of cataract phacoemulcification was divided into 4 sections and 15 steps in this study.The surgery was taught to the basic level doctors step by step.A total of 13 local eye doctors were included in the study ( 6 in the traditional teaching group and 7 in novel teaching group) .The effects of teaching were compared between two groups.Results In the traditional teaching group, 2/6 of doctors were able to independently operate cataract emulcification surgery during 12 weeks of teaching time;while in the new teaching group, the rate is 6/7.In traditional teaching group, 4/6 of the doctors encountered severe surgical complications.However, none of the doctors encountered severe complications in novel teaching group during the teaching period(χ2=0.02,P=0.02).The mean number of complications which affected the visual prognosis of patients was (10.8±7.5) in traditional teaching group, and it was(2.3±1.8) in the novel teaching group(t=2.72,P=0.04).Conclusion The novel teaching model is efficient.