腹腔镜基础技能模拟培训BEST课程的实施效果与思考

Implementation effect and thought of the basic essential surgical training course of laparoscopic skills

目的:分析总结近10年腹腔镜基础技能模拟培训课程实施效果及课程内容与模具更新的实践经验。方法:收集2012年至2022年参加腹腔镜基础技能模拟培训(basic essential surgical technique training,BEST)课程的学员的课前评估问卷、腹腔镜基本操作考核成绩及课后评估问卷等信息。按照课程建设的时间段分为两组,即参加前期使用单一培训系统课程的学员(传统组)和后期课程模具更新后使用多种培训系统整合课程的学员(试验组)。比较两组学员完成轨道移圈、穿隧道和高低柱3项操作的客观成绩及学员对课程设置、实施效果方面的主观课程反馈评价。研究依照数据类型使用SPSS 13.0分别进行t检验、Wilcoxon检验或卡方检验。结果:150名传统组学员完成轨道移圈、穿隧道和高低柱3项的用时分别是1.08 min(0.81 min,1.60 min)、2.20 min(1.60 min,3.27 min)和4.86 min(3.28 min,6.36 min),而75名试验组学员对应用时为1.27 min(0.87 min,1.83 min)、2.57 min(1.58 min,4.07 min)和4.35 min(2.90 min,6.42 min),差异均无统计学意义(P>0.05)。学员对课程评价方面,试验组学员在课堂环境氛围、授课方式安排、培训设备器械、培训练习机会、助力临床工作及符合课前预期这6项的主观评价满意百分率均高于传统组。结论:不断更新的BEST课程可保证学员的培训质量并获得学员们对课程更高的满意度,而本课程对临床实际中的获益可通过对这些培训学员进行长期随访而进一步验证。

Objective To analyze and summarize the implementation effect of basic essential surgical training(BEST)course of laparoscopic skills over the past 10 years and the practical experience in updating course content and models.Methods The pre-class assessment questionnaires,basic laparoscopic operation assessment results,and post-class assessment questionnaires of the students who participated in the BEST course of laparoscopic skills were collected.According to the period of the course construction,the students were divided into two groups,namely students who used the course of single training system in the early stage(traditional group)and students who used the course integrating a variety of training systems after the course model was updated in the later stage(test group).The two groups were compared for the scores of track circle moving,tunnel crossing,and high and low columns,as well as their subjective evaluation of course setting and implementation effect.The t-test,Wilcoxon test,or chi-square test was conducted according to the data type using SPSS 13.0.Results The time for 150 traditional group students to complete track circle moving,tunnel crossing,and high and low columns was 1.08 min(0.81 min,1.60 min),2.20 min(1.60 min,3.27 min),and 4.86 min(3.28 min,6.36 min),respectively,while the time for 75 test group students to complete the three operations was 1.27 min(0.87 min,1.83 min),2.57 min(1.58 min,4.07 min),and 4.35 min(2.90 min,6.42 min),respectively,with no significant difference between the two groups(P>0.05).In terms of students'subjective evaluation of the course,a higher percentage of the test group students were satisfied with classroom environment,teaching method arrangement,training equipment,training opportunities,helping clinical work,and meeting pre-class expectations than those in the traditional group.Conclusion The constantly updated BEST course can ensure the training quality of trainees and obtain their higher satisfaction.The benefits of this course in clinical practice can be further verified through long-term follow-up of these trainees.