结合TBL教学模式的显微外科技术训练在外科住院医师规范化培训中的应用

Application of the TBL teaching model in microsurgery technology training which provides standardize training for surgical residents

目的针对外科住院医师规范化培训学员,探讨结合以团队为核心(team based learning,TBL)的教学模式在显微外科技术培训中的效果。方法采用TBL教学模式对武汉大学中南医院2018年至2019年48名外科住院医师规范化培训学员进行显微外科技术培训。培训内容包括小血管吻合培训、组织瓣移植的尸体演示与临床手术带教三部分。培训前后分别对小血管吻合培训、组织瓣移植尸体演示进行问卷调查,内容涉及相关知识了解程度等,同时对培训前后学员小血管吻合技术操作与临床显微外科手术操作进行考核并评分。结果学员对小血管吻合技术、组织瓣移植技术完全了解人数均由培训前的0人提高至培训后的48人,感觉非常困难、无法掌握的人数均由24人下降到培训后的3人。培训后小血管吻合技术操作平均总分(11.54±1.88 vs.7.40±1.65,P<0.05)、临床手术带教平均总分(11.45±1.76 vs.7.52±1.41,P<0.05)均较培训前显著提高。结论应用TBL教学模式对提高外科住院医师规范化培训学员显微外科技术具有良好的教学效果。

Objective Aiming at to evaluate the standardized training for surgical resident students,this paper discusses the effect of the team based learning(TBL)teaching model applied to microsurgical technology training.Methods 48 surgical resident trainees undergoing standardized training in Zhong Nan Hospital of Wuhan University from 2018 to 2019 were trained in microsurgery technology using the TBL teaching model.The training content included three parts:small vessel anastomosis training,cadaveric demonstration of tissue flap transplantation and clinical operation teaching.A questionnaire survey was administered before and after the training covering the training of small vessel anastomosis and the demonstration of tissue flap transplantation cadavers which included the understanding of relevant knowledge.The practices of the technical operation of small vessel anastomosis and clinical microsurgical operations performed by the trainees before and after the training were also assessed and scored.Results The number of trainees who fully understood the small vessel anastomosis technology and tissue flap transplantation technology increased from 0 before training to 48 after training;the number of trainees who felt it was very difficult and were unable to grasp it decreased from 24 to 3 after training.After training,the average total score of small vessel anastomosis technique operation(11.54±1.88 vs.7.40±1.65,P<0.05)and the average total score of clinical surgery teaching(11.45±1.76 vs.7.52±1.41,P<0.05)were all significantly higher than those before training.Conclusion The application of the TBL teaching model has a good effect on improving the teaching of the microsurgical technology module of standardized training for surgical resident students.