运用情景模拟与快速读片方法提升放射科颈椎DR教学质量的研究

Improving the teaching quality of cervical vertebra DR in radiology department with scenario simulation and rapid film reading

目的探讨情景模拟与快速读片培训方法在放射科颈椎DR检查技术规范化建立中的应用。方法采用检查室情景模拟拍摄颈椎DR片的方法,由两位高年资主管技师从患者核对、曝光条件、体位摆放、胶片打印、检查安全及辐射防护等方面,对低年资技师的不足进行评价指导。每日晨间随意抽取颈椎DR图像进行快速阅片,让初级技师在1 min内快速地浏览完图像并作出质控评价,并由高年资主管技师指出评价的不足之处和改进方法;随后通过每位技师的不足及发现的问题整理成颈椎DR检查技术规范手册。随机筛选规范化建立前后年龄18~55岁、行动无异常、无内固定颈椎常规投照患者各200例,规范前为A组、规范后为B组,分别比较A、B两组图像质量、重复投照率。采用SPSS 25.0统计软件对数据进行整理分析。结果B组图像质量评分(8.83±0.33)高于A组(8.45±0.30),B组重复投照率(2%)低于A组(9%),差异有统计学意义(P<0.05)。结论通过快速读片与情景模拟培训模式,建立适合科室情况的颈椎DR检查技术的规范,有效解决了放射科技术教学抽象化的问题;建立颈椎DR检查技术的规范,让各技师参与规范化建立及培训过程,较快掌握科室工作流程及相应检查技术,在规范化培训中发挥了重要作用。

Objective To explore the application of scenario simulation and rapid film reading training in the standardization of cervical vertebra DR examination in radiology department.Methods Using the method of scene simulation in the examination room to take DR films of cervical vertebra,two senior technicians in charge evaluated and guided the deficiencies of junior technicians from the aspects of patient check,exposure conditions,body position placement,film printing,inspection safety and radiation protection.Every morning,DR images of cervical vertebra were randomly selected and read quickly,and the junior technicians should quickly browse the images within one minute and make quality control evaluation.Then the senior technician in charge pointed out the shortcomings of the evaluation and related improvement methods.After that,the technical specification manual of cervical vertebra DR was compiled based on the deficiencies and problems found by each technician,and 200 patients aged 18-55 years,without abnormal movement and no internal fixation before and after the establishment of standardization were randomly selected in group A(before standardization)and group B(after standardization).The image quality and repetition projection rate of group A and group B before and after the standardization were compared.SPSS 25.0 was used to analyze the data.Results The image quality score of group B(8.83±0.33)was higher than that of group A(8.45±0.30),and the repetition projection rate of group B(2%)was lower than that of group A(9%),with statistical significance(P<0.05).Conclusion Through the training mode of rapid film reading and scenario simulation,the standardization of cervical vertebra DR examination technology suitable for the situation of the department has been established,which effectively solves the problem of abstraction in the technical teaching of radiology department.The standardization establishment plays an important role in standardized training,for which,the technicians can quickly grasp the work process of the department and the corresponding examination technology during participating in the standardization establishment and training process.