麻醉科住院医师规范化培训桡动脉穿刺置管术教学方式的探讨

Discussion on the teaching method of radial artery puncture and catheterization in anesthesia resident standardized training

目的对改进麻醉科住院医师规范化培训中桡动脉穿刺置管术的教学方式进行探讨。方法采取整群抽样法选择未接受过桡动脉穿刺置管术培训的浙江省宁波市医疗中心李惠利医院麻醉科住院医师规范化培训55名学员为研究对象,将其随机分为试验组和对照组。试验组29名学员采用改进的"自学-教学互动-实战集训"教学方式,对照组26名学员采用传统教学方式。培训后,通过理论知识、技能操作考核成绩和问卷调查结果,比较两组学员培训效果。结果理论知识和技能操作考核成绩比较,试验组学员[(86.83±4.38)分、(92.83±3.49)分]均高于对照组学员[(82.58±4.16)分、(84.69±5.97)分];试验组学员一次桡动脉穿刺置管成功率、穿刺成功率(61/87、82/87)均高于对照组学员(39/78、62/78);试验组学员平均每例穿刺次数[(1.37±0.61)次]少于对照组学员[(1.74±0.83)次]。问卷调查结果显示,试验组学员学习状态满意度、教学计划满意度和桡动脉穿刺置管术掌握程度满意度均高于对照组学员。两组学员上述各项数据比较,其差异均具有统计学意义(均P<0.05)。结论"自学-教学互动-实战集训"教学方式可以提高麻醉科住院医师规范化培训学员桡动脉穿刺置管术培训的教学质量,学员的认可度更高,具有推广应用价值。

Objective To investigate the teaching mode of improving of radial arterial puncture cannulation for anesthesia residents standardized training.Methods Fifty-five anesthesia standardized training residents from Zhejiang Ningbo Medical Center Lihuili Hosipital who had not received arterial puncture cannulation training by cluster sampling,were randomly divided into two groups.The experimental group was taught with“Study independently-teaching interaction-strengthen operating”teaching model,while the control group was taught with traditional teaching model.Training results through the theoretical and skill scores and questionnaire survey between the two groups after training were compared.Results Theoretical and skill scores in experimental group(86.83±4.38,92.83±3.49)were higher than the control group(82.58±4.16,84.69±5.97).Success rate of the first puncture and the success rate of puncture in experimental group(61/87,82/87)were higher than those of the control group(39/78,62/78).Mean number of punctures per patient in experimental group(1.37±0.61)was less than the control group(1.74±0.83).According to the questionnaire survey,the satisfaction of learning status,the teaching plan,and mastery of radial artery puncture cannulation in experimental group were higher than those of the control group.Above results of the two groups were statistically significant(all P<0.05).Conclusions“Study independently-teaching interaction-strengthen operating”teaching model can promote the teaching quality of radial arterial puncture cannulation for anesthesiology residents,and the residents are more recognized,has the value of promotion and application.