经食道超声心动图模拟训练系统在麻醉规培带教中的应用

Application of transesophageal echocardiography simulation training system in standardizedtraining and teaching of anesthesia residents

目的:探讨经食道超声心动图(transesophageal echocardiography,TEE)模拟训练系统是否能够提高麻醉规培医师的教学效果。方法:将72名没有心脏超声基础的麻醉专业住院医师随机分为传统教学组(36人)和模拟训练组(36人)。授课前后均进行涵盖5个心超相关知识点的理论考核,规范化轮转2个月后对学员再次进行理论及操作考核,并记录临床相关指标。采用SPSS 23.0进行t检验、秩和检验、卡方检验或Fisher精确概率法。结果:两组学员授课前理论成绩差异无统计学意义。授课后模拟训练组学员理论成绩高于传统教学组,且切面识别及图像诊断题差异有统计学意义(P<0.05)。轮转后,两组学员理论成绩差异无统计学意义,但操作考核成绩模拟训练组明显优于传统组(P<0.05)。轮转期间,模拟教学组TEE相关并发症的发生率低,且临床操作技能评估量化评分较高(P<0.05)。结论:麻醉住院医师在进行TEE培训前预先接受模拟系统训练,能够更快地掌握操作技能,减少相关并发症发生,更准确地识别和获得TEE标准切面,对临床教学具有重要价值。

Objective To explore whether the simulation training system for transesophageal echocardiography(TEE)can improve the effectiveness of standardized training of resident anesthesiologists.Methods A total of 72 resident anesthesiologists without experience in cardiac ultrasound were randomly divided into traditional teaching group(36 residents)and simulation training group(36 residents).Before and after the teaching,theoretical examinations of 5 knowledge points related to cardiac ultrasound were conducted.After a standardized rotation of 2 months,the students were re-examined for both theories and operations,and clinical indicators were recorded.SPSS 23.0 was used for the t-test,rank sum test,chi-square test,or Fisher's exact test.Results There was no significant difference in scores of theoretical examinations between the two groups of students before teaching.After teaching,the scores of the simulation training group were higher than those of the traditional teaching group,and the differences were significant in cross-sectional recognition and image diagnosis(P<0.05).After rotation,there was no significant difference in theoretical examination between the two groups of students,but the score of operation was significantly higher in the simulation training group than in the traditional teaching group(P<0.05).During the rotation period,the incidence of TEE-related complications was relatively low and the quantitative score of clinical operational skill assessment was relatively high in the simulation training group(P<0.05).Conclusion Anesthesia residents who receive training with the simulation system before TEE training can quickly acquire operational skills,reduce related complications,and more accurately identify and obtain standard TEE sections,which has significant value for clinical teaching.