模拟运作专员在住院医师规范化培训模拟课程中的需求研究

Research on the demand of simulation operations specialists in simulated courses in standardized residency training

目的分析住院医师规范化培训中模拟教学模块对模拟运作专员(simulation operations specialists,SOS)的需求及其实际效用。方法基于瑞金临床医学院住院医师规培模拟课程的实施反馈,调研了2017至2018学年参与该课程的全部住培医师、教员及SOS的主观评价,采用手机端在线调研,同时纳入相关课程教师地图的设计数据。应用SPSS 13.0进行t检验和卡方检验。结果①目前基于高端模拟人的住培情景模拟课仅使用了26.3%的预设功能,教员对功能的掌握不到30%,而SOS参与了全部的课程准备及63.6%的课程运作,高于教师地图的要求(45.5%)。其中心电监护调控、静脉管理、特效化妆的需求最大,同时也是教员需求与掌握程度差值最大的项目。②住培医师需要SOS替代教员来操控教学设备以减少课程的中断感(37.0%)、暗示作用(31.3%)和提升体验感(32.3%);且临床学科专业医师较辅助学科专业医师更需要SOS的协助(tQ3=3.204,tQ4=2.573,tQ5=2.660;P<0.05)。③SOS的实际工作内容与职能要求存在差异(χ^2=12.632,P<0.01)。结论在住培模拟课程中SOS作用显著,尤其应注重在临床专业医师模拟课程中的参与。教具管理、特效化妆、教程设计、适宜的SP职能等模拟课程辅助能力是目前对SOS最主要的需求;良好的住培模拟课程需要教员与SOS的共同参与。

Objective To investigate the demand and practical utility of simulation operations specialists(SOS)in simulation teaching modules during the standardized residency training.Methods Based on the feedback for stimulated courses of standardized residency training,subjective evaluation of all residents,teachers and SOS who participated in simulation courses in 2017-2018 academic year were investigated and studied via the mobile phone online investigation.At the same time,the design data of teaching concept map of relevant curriculum were also included.The SPSS 13.0 was used to conduct the t test and chi-square test.Results At present,only 26.3%of the preset functions were used in the medical simulation courses based on high-tech medical simulator.Tutors commanded less than 30%functions,while SOS participated in the whole process of the course preparation and commanded 63.6%of the course operations,which was higher than the requirement of teaching concept map(45.5%).Among them,ECG monitoring regulation,venous management and special effects makeup were in greatest needs and were items with the biggest gap between ideality and reality.Resident physicians required SOS to replace the tutors to operate teaching facilities,so as to reduce interruption(37.0%),implications(31.3%)during courses,and improvement of experience sense during the course(32.3%).Furthermore,specialists with clinical background needed more assistance from SOS than those without clinical background(tQ3=3.204,tQ4=2.573,tQ5=2.660;P<0.05).Differences were found between the actual work content of SOS and their job requirement(χ^2=12.632,P<0.01).Conclusion SOS plays a significant role in the simulation course of standardized residency training,especially in the course of clinical professional physicians.Auxiliary functions of simulated courses,such as teaching aids management,special effects makeup,course designing,qualified SP and others are the main necessities for SOS at present.Participation of tutors and SOS together is essential to ensure a good development and performance of medical simulation courses for standardized residency training.