多模态神经导航技术在神经肿瘤手术教学中的应用

Application of Multimodal Neuronavigation System in clinical teaching of neural tumor surgery

目的探讨多模态导航技术在神经肿瘤手术教学中的作用,以期改善专科医师规范化培训的培养方法。方法通过专家调查法制定调查问卷,获得20名住院医师的详细资料,随机分为传统教学组(10人)和多模态导航组(10人),利用柯式模型,从反应层、学习层、行为层和结果层四方面进行比较和评价,采用SPSS 17.0进行统计分析,定量资料采用(均数±标准差)进行描述,定性资料采取率或百分比描述,同时采用两独立样本t检验进行两组的相互对比。结果反应层结果表明,多模态导航组学员在培训内容、培训方法、培训设施和培训后感受四方面的评分都明显比传统教学组高(P<0.05);学习层结果表明,多模态导航组的住院医师的理论考试成绩、手术技能操作成绩以及总成绩更高(P<0.05);行为层结果表明,多模态导航组医师实践能力更加突出(P<0.05),集中表现在解剖结构的理解,术前手术方案的设计和术中的手术能力三方面;成果层结果表明,在带教教师的指导下,多模态导航组能够完成全部手术过程的人数比例更高(50% vs. 20%)。结论多模态导航技术的应用对于神经外科专业医师规范化培训具有积极的意义,尤其在神经肿瘤的解剖结构教学、手术教学改革方面发挥着重要作用。

Objective To improve the system of specialized training by exploring the role of multimodal navigation in the teaching of neurosurgery. Methods The questionnaire was conducted by the experts to obtain the detailed information of 20 residents. They were randomly divided into two groups: the traditional teaching group (n=10) and the multimodal navigation group (n=10). The details were evaluated from the reaction layer, the learning layer, the behavior layer and the result layer by the Kirkpatriek’s model. The data were analyzed by SPSS 17.0. The quantitative data were described by mean±standard deviation and the qualitative data was described by rate or percentage. Two independent-samples t test was used to compare the results of two groups. Results The results of the reaction layer showed that the scores of the multimodal navigation group were significantly higher than those of the traditional teaching group, which were statistically significant (P<0.05) in the training content, training methods, training facilities and experience after training. The learning results showed that the multimodal navigation group had higher scores in the theoretical examinations, surgical skills and overall scores (P<0.05). The behavioral results showed that the clinical ability of the multimodal navigation group was more prominent (P<0.05). The result layer showed that under the guidance of professors, the percentage of residents who can complete the whole surgical operation is higher in multimodal navigation group (50% vs. 20%). Conclusion The application of multimodal navigation technology has a positive effect on the teaching of neurosurgery and specialized training of residents.