精细化和程序化操作理念引导下的介入手术教学模式的应用

Exploration of an Interventional procedure teaching model guided by the concept of step-by-step operations

目的:探讨精细化和程序化操作理念引导下的介入手术教学模式在介入放射科住院医师规范化培训临床教学中的应用。方法:该研究纳入了42名住院医师规范化培训学员。教学研究组22人,传统手术教学组20人。传统手术教学组的学员采用PPT或视频教学的方式讲解介入手术的适应证、手术过程及并发症的处理,以及术中的血管解剖。教学研究组则采用“精细化和程序化介入手术”的培训方式。培训期满后两组学员进行手术适应证、手术过程及并发症处理、血管解剖四项考核,由手术室护理人员对学员评分。结果:教学研究组学员得分高于传统手术教学组,差异有统计学意义(P<0.001),其中在血管解剖和手术过程及并发症处理方面,教学研究组学员得分高于传统手术教学组,差异具有统计学意义(P<0.05)。在手术适应证和手术室护理人员评分方面两组得分差异没有统计学意义(P>0.05)。教学研究组学员的总体满意率为90.9%,与传统手术教学组的总体满意率65.0%比较更高,差异有统计学意义(P=0.041)。结论:精细化程序化操作理念引导下的介入手术教学模式在介入手术临床教学中是有效可行的。

Objective:Exploring the step-by-step interventional procedure training model in the clinical teaching of the standardized training of interventional resident physicians.Methods:Forty-two residents in standardized residency training were included in this study.There were 22 in the teaching and research group and 20 in the traditional surgery teaching group.The participants of the traditional surgical teaching group were taught the indications for interventional procedures,surgical procedures and management of complications,as well as intraoperative vascular anatomy by means of PPT or video teaching.For the teaching and research group,the training method of"the step-by-step interventional procedure training model"was adopted.After the internship expires,the two groups of trainees will be evaluated.The assessment includes surgical indications,surgical process and complications,vascular anatomy,and the evaluation of the trainees by the nursing staff in the operating room.Results:The total score of the doctors in the research group was higher than that in the traditional teaching group,and the difference was statistically significant(P<0.001).In terms of vascular anatomy,surgical,process,and treatment of complications,the scores of the students in the research group were higher than those in the traditional teaching group.The difference was statistically significant(P<0.05).There was no significant difference in scores between the two groups in terms of surgical indications and nurse's comments(P>0.05).The overall satisfaction rate of the regular-training physicians in the research group was 90.9%,compared with the traditional teaching group,the regular-training physicians of 65.0%was significantly higher(P=0.041).Conclusions:The step-by-step interventional procedure training model in the clinical teaching of resident physicians is effective and feasible.