肝脏外科的三维可视化实践教学在住院医师规范化培训中的应用效果

Application effect of three-dimensional visual practice teaching of liver surgery in standardized residency training

目的探讨三维可视化技术用于住院医师规范化培训肝脏外科实践教学的效果。方法选取吉林大学第一医院2019年2月至2019年6月60名肝胆外科本科住院医师作为研究对象,随机分为两组,分别为传统教学组和三维教学组,每组各20人。对照组采用卫生部外科学教材、肝脏外科手术图谱、肝脏教学模型及手术视频进行教学;实验组采用肝脏三维可视化影像、虚拟手术系统及科室既往手术视频及真实高清手术视频进行教学。学习周期为8学时,结束后对所有住院医师进行闭卷标准化考试,同时利用反馈问卷调查所有住院医师对教学的满意度。结果实验组住院医师的平均成绩为(92.3±3.2)分,对照组住院医师的平均成绩为(84.6±4.1)分,两组相比,差异具有统计学意义(P<0.05)。90分以上人数,实验组(12人,40%)明显多于对照组(5人,17%),差异具有统计学意义(P<0.05)。调查问卷结果显示,实验组住院医师认为三维可视化影像教学法生动形象,更易于掌握肝脏解剖知识,虚拟的手术教学软件能够充分调动住院医师学习积极性,更有利于复杂知识的学习与掌握,提高了住院医师对肝脏解剖的三维空间想象力,尤其对未来拟从事肝胆外科工作的住院医师意义深远,提高了他们利用现代化信息技术手段进行诊断和治疗的自主学习能力。结论利用三维可视化技术及其虚拟手术操作系统对住院医师的实践教学效果明显优于传统教学方法,有效提高了教学质量,值得推广。

Objective This article aimed to explore the effect of three-dimensional visualization technology in the practice teaching of liver surgery in standardized residency training. Methods 60 undergraduate hepatobiliary surgery residents from the first hospital of Jilin university from February 2019 to June 2019 were selected as the research objects. They were randomly divided into two groups: traditional teaching group and 3 d teaching group, with 20 members in each group. In the control group, teaching materials, operation atlas, liver models and operation videos were used as the national health department required. In the experimental group, liver 3 d visualization models, virtual surgery systems and previous surgery videos and real hd surgery videos of the department were used for teaching. At the end of the 8-hour learning period, all residents were given a closed-book standardized test, and feedback questionnaires were used to investigate all residents’ satisfaction degrees with teaching. Results The average score of students in the experimental group was(92.3±3.2), and that of students in the control group was(84.6±4.1), the difference was statistically significant(P<0.05). The number of people with 90 points or more in the experimental group(12, 40%) was significantly higher than that in the control group(5,17%), and the difference was statistically significant(P<0.05). Questionnaire results showed that the residents of the experimental group thought 3 d visualization image teaching was more vivid and easier for them to grasp the liver anatomical knowledge. Virtual surgery teaching software could fully mobilize the learning enthusiasms of the residents, and were more conducive to complex learning and mastering of knowledge. It improved the residents’ three-dimensional imagination in terms of the liver anatomy and promoted their autonomous learning abilities of applying modern information technology means for the diagnosis and treatment, which was especially of far-reaching significance for residents who would become liver and gallbladder surgery specialists in the future. Conclusion The application of 3 d visualization technology and virtual surgical operating system to the clinical practice of residency training is obviously superior to the traditional teaching method, which effectively improves the teaching quality and is worth popularizing.