急性ST段抬高型心肌梗死情景模拟教学在“5+3”专业型硕士培训中的应用

The application of scenario simulation teaching in acute ST-segment elevation myocardial infarction course for the training of"5+3"professional master

目的探索急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)情景模拟教学在"5+3"专业型硕士急诊培训中的应用可行性和效果。方法以STEMI急诊处理为教学内容,将48名即将进入急诊轮转的"5+3"专业型硕士随机分为情景模拟教学组(24人)和传统教学组(24人)。情景模拟教学组通过模拟急诊室、标准化病人和急救模拟人全真模拟STEMI急诊室处理流程进行教学,传统教学组采用常规课堂教学。课程完成后对两组学生进行"理论考试"和"问卷调查"以评价教学效果。前者进一步分"胸痛的首诊和鉴别诊断""STEMI的快速识别和处理"及"心跳骤停的抢救"情景进行组间和组内评价。采用SPSS 20.0进行t检验。结果在反映学生急诊应对STEMI的理论考试中,情景模拟教学组均分高于传统教学组[(82.38±2.41)vs.(68.00±1.95),t=4.64,P<0.001];在3个情景考核均分差异都有统计学意义。情景模拟教学组内分析显示:角色扮演学生均分高于非角色扮演学生[(90.50±3.04)vs.(79.67±2.79),t=2.09,P=0.049];前两个情景考核均分差异有统计学意义。问卷调查显示,情景模拟教学组对各项教学的满意度都高于传统教学组。结论在STEMI急诊处理培训中,情景模拟教学相较传统教学有着较大优势,值得进一步推广。

Objective To explore the application and effect of scenario simulation teaching in ST-segment elevation myocardial infarction(STEMI)course for emergency training of"5+3"professional master.Methods A randomized controlled trial was conducted among 48"5+3"professional masters who would rotate in the emergency department,to compare the test results of the total and three scenes between scenario simulation teaching group(n=24)and traditional teaching group(n=24).The STEMI teaching was carried out through simulating the emergency room,standardized patients and first-aid simulators in the simulation teaching group,and the traditional teaching group was taught by conventional classroom teaching.After the class,"Theoretical Examination"and"Questionnaire Survey"were used to evaluate the teaching effect.The former was further divided into"first diagnosis and differential diagnosis of chest pain","fast identification and processing of STEMI"and"rescue of cardiac arrest"for inter-group and intra-group evaluation.SPSS 20.0 was used to conduct t-test.Results In the theoretical examination,the scenario simulation teaching group was superior to the traditional teaching group in the test of emergency processing for STEMI course[(82.38±2.41)vs.(68.00±1.95),t=4.64,P<0.001].In the sub-analysis of scenario simulation teaching group,students in the role-play group had significantly higher scores than others in the non-role-play group[(90.50±3.04)vs.(79.67±2.79),t=2.09,P=0.049].Scenario simulation teaching group was also superior to traditional teaching group in the"Questionnaire Survey".Conclusion In the training and teaching of STEMI emergency processing,scenario simulation teaching group proves to be superior to traditional teaching,which deserves further promotion.