基于柯氏四级培训评估模型的胸腔镜微创外科手术培训效果分析

The effect analysis of thoracoscopic minimally invasive surgery training based on Kirkpatrick's four-level training evaluation model

目的 基于柯氏四级培训模型探讨结核病胸腔镜微创外科手术培训的效果,为改进相关临床培训项目提供依据。方法 以2020年2月至2023年6月在新疆医科大学第八附属医院参与结核病胸腔镜微创外科手术培训的中亚国家的54名学员为研究对象展开前瞻性研究。对学员培训前、培训结束时以及培训后3个月进行问卷调查。通过柯氏四级培训评估模型[反应层(培训满意度)、学习层(理论考核、操作考核、整体评价)、行为层(临床护理能力得分、领导力、人际关系与沟通交流、伦理与法律实践、专业发展、教育与咨询、评判性思维与科研)、结果层(医疗护理差错与有效投诉发生情况)]对培训结果进行分析。结果 反应层评估结果显示,54名学员对参加培训的收获、培训内容的实用性、培训方法的评价、授课老师的评价、培训总体评价的满意度得分分别为(4.61±0.56)分、(4.67±0.48)分、(4.52±0.57)分、(4.65±0.52)分、(4.59±0.53)分;学习层评估结果显示,培训后理论考核(95.19±2.07)分、操作考核(93.22±2.60)分、整体评价(97.15±1.55)分,均高于培训前(82.43±6.56)分、(80.98±5.20)分、(82.30±6.27)分(P<0.05);行为层评估结果显示,培训后临床护理能力(4.37±0.65)分、领导力(4.09±0.71)分、人际关系与沟通交流(4.72±0.66)分、伦理与法律实践(4.65±0.65)分、专业发展(4.57±0.72)分、教育与咨询(4.41±0.71)分、评判性思维与科研(4.35±0.73)分,均高于培训前(3.83±0.61)分、(3.57±0.50)分、(4.02±0.31)分、(3.96±0.39)分、(3.98±0.36)分、(4.02±0.31)分、(3.72±0.53)分(P<0.05);结果层评估结果显示,54名学员自参与培训后至2023年10月,无医疗、护理差错与有效投诉事件发生。结论 开展外科手术前参加规范化的技术培训课程非常重要,通过参与结核病胸腔镜微创外科手术培训可有效促进医生与护士临床实践能力提高,柯氏四级培训评估可有效验证培训方案的有效性。

Objective To explore the effect of minimally invasive thoracoscopic surgery training based on Kirkpatrick's four-level training model,and to provide a basis for improving related clinical training programs.Method A prospective analysis was conducted on 54 trainees from Central Asian countries who participated in the training of tuberculosis minimally invasive thoracoscopic surgery in the Eighth Affiliated Hospital of Xinjiang Medical University from February 2020 to June 2023.A questionnaire survey was conducted before the training,at the end of the training and 3 months after the training.The training results were analyzed by Kirkpatrick's four-level training evaluation model[reaction layer (training satisfaction),learning layer (theoretical assessment score,operation assessment score,overall evaluation),behavior layer (clinical nursing ability score,leadership score,interpersonal relationship and communication score,ethics and legal practice score,professional development score,education and consultation score,critical thinking and scientific research score),outcome layer (Nursing errors and effective complaints)].Result The evaluation results of the response layer showed that the training satisfaction scores of 54 trainees for the harvest of training,the practicability of training content,the evaluation of training methods,the evaluation of teachers,and the overall evaluation of training were (4.61±0.56),(4.67±0.48),(4.52±0.57),(4.65±0.52),and (4.59±0.53),respectively.The evaluation results of the learning layer showed that the theoretical assessment scores(95.19±2.07),operation assessment scores(93.22±2.60)and overall evaluation after training scores(97.15±1.55)after training were higher than those before training(82.43±6.56),(80.98±5.20)and(82.30±6.27)(P<0.05).The evaluation results of the behavior layer showed that the scores of clinical nursing ability(4.37±0.65),leadership(4.09±0.71),interpersonal relationship and communication(4.72±0.66),ethical and legal practice(4.65±0.65),professional development(4.57±0.72),education and consultation(4.41±0.71),critical thinking and scientific research(4.35±0.73) after training were higher than those before training(3.83±0.61),(3.57±0.50),(4.02±0.31),(3.96±0.39)、(3.98±0.36),(4.02±0.31)and(3.72±0.53)(P<0.05).The evaluation results of the outcome layer showed that there were no medical and nursing errors and effective complaints among 54 trainees since they participated in the training until October 2023.Conclusion It is very important to participate in standardized technical training courses before surgery.The training of thoracoscopic minimally invasive surgery for tuberculosis can effectively improve the clinical practice ability of doctors and nurses.Kirkpatrick four-level training evaluation can effectively verify the effectiveness of the training program.