两种经胸心脏超声模拟器的教学效果比较

Comparision of the Teaching Effectiveness of Two Different Simulators in Transthoracic Echocardiography Skills

目的评估两种经胸心脏超声(transthoracic echocardiography,TTE)模拟器的教学效果。方法前瞻性纳入2016年1月1日至12月31日期间,在北京协和医院麻醉科接受规范化培训并自愿报名参加此项目的63名住院医师。参与者被随机分为3组[Heartworks组(使用Heartworks模拟器)、U/S Mentor组(使用U/S Mentor模拟器)及对照组(接受传统教学形式培训)],每组21人。教学效果评估指标包括培训前后的基础知识笔试(总分分别为100分)、培训后针对健康志愿者的实际操作考核[包括获取图像质量(总分25分)和心脏解剖结构识别(总分25分)两部分]以及学员对教学模式的满意度测评(3个等级)。结果培训前Heartworks组、U/S Mentor组及对照组的笔试成绩分别为(41.4±10.6)分、(40.4±10.9)分和(39.8±10.5)分,3组间无统计学差异(P>0.05),培训后3组的笔试成绩分别为(53.8±12.6)分、(52.6±13.6)分和(43.3±10.8)分,均高于各组培训前成绩(P均<0.05),其中Heartworks组和U/S Mentor组间无统计学差异(P>0.05),但均高于对照组(P均<0.05)。培训后3组获取图像质量的考核成绩依次为(17.1±4.5)分、(16.0±4.1)分和(7.7±3.1)分,心脏解剖结构识别考核成绩依次为(18.2±6.3)分、(17.0±6.1)分和(11.9±6.9)分,两组成绩中Heartworks组和U/S Mentor组间无统计学差异(P均>0.05),但均高于对照组(P均<0.05)。3组间满意度测评无统计学差异。结论Heartworks和U/S Mentor两种模拟器的TTE教学效果近似,均优于传统授课型培训模式。

Objective The aim of this study was to evaluate the training effect of two different simulators of transthoracic echocardiography(TTE).Methods Sixty-three residents who received the standardized training and volunteered to participate in this project in the Department of Anesthesiology of Peking Union Medical College Hospital from January 1 st to December 31 st,2016 were perspectively enrolled and randomly divided into 3 groups(21 in each group):Heartworks group(using Heartworks simulator),U/S Mentor group(using U/S Mentor simulator),and the control group(traditional teaching method).The evaluation index of teaching effect included the written test scores about the TTE basic knowledge before and after training(the total score was 100 points),the practice examination on volunteer models after the training[including the quality of images(the total score was 25 points)and the ability of identifying cardiac anatomical structures(the total score was 25 points)],and the satisfaction assessment by the participants(3 levels).Results The written test scores of the Heartworks,U/S Mentor,and the control groups before training were 41.4±10.6,40.4±10.9,and 39.8±10.5,respectively;there was no statistical difference among the three groups(P>0.05).The scores of the above three groups after training were 53.8±12.6,52.6±13.6,and 43.3±10.8,respectively,which were higher than before(all P<0.05)in each group,and there was no statistical difference between the Heartworks and the U/S Mentor groups(P>0.05),while both were higher than that of the control group(both P<0.05).After the training,the scores of image quality of the Heartworks,U/S Mentor,and the control group were 17.1±4.5,16.0±4.1,and 7.7±3.1,respectively;and the scores of recognition of cardiac anatomical structures were 18.2±6.3,17.0±6.1,and 11.9±6.9,respectively;there were no statistical difference between the Heartworks and the U/S Mentor groups(P>0.05),while both groups had higher scores than the control group(both P<0.05).There was no statistical difference in the satisfaction among the three groups.Conclusions The TTE training effect of the Heartworks and U/S Mentor simulators is similar,and both modes are better than the traditional training mode based on the lecture.