基于虚拟仿真系统的PBL教学法在单人电子结肠镜培训中的应用

Application of Problem-Based Learning Based on Virtual Simulation System in Single Colonoscopy Training

目的 探讨基于虚拟仿真系统的PBL(problembased learning,PBL)教学法在单人电子结肠镜培训的应用。方法 选取2018年1月—2021年12月在连云港市第一人民医院消化内镜中心学习单人结肠镜操作的消化内科住院医师规范化培训(以下简称“住培”)医师、消化专业临床型研究生及进修学员共84名为研究对象。根据随机数表法分为试验组与对照组,每组42名。试验组采用基于虚拟仿真系统的PBL教学法,对照组采用传统教学法,比较2组2周后理论考核成绩,12周后回盲部进镜成功率、进镜长度、操作时间、消化内镜技能-结肠镜检查评分(gobal assessment of gastrointestinal endoscopic skills-colonoscopy,GAGES-C)、报告书写合格率及学员满意度。结果 试验组的理论考核成绩、回盲部进镜合格率均高于对照组,差异有统计学意义(P <0.05);进镜长度短于对照组,差异有统计学意义(P <0.05);进镜时间短于对照组,差异有统计学意义(P <0.05);学生满意度高于对照组,差异有统计学意义(P <0.05)。GAGES-C评分中试验组内镜运动轨迹的操控评分、进镜技巧评分、总体熟练程度评分及总分[(4.1±0.4)分、(4.2±0.4)分、(4.3±0.3)分、(21.2±1.4)分]均高于对照组[(3.8±0.5)分、(3.9±0.4)分、(3.9±0.3)分、(19.9±1.5)分],差异有统计学意义(P <0.05)。2组维持内镜视野清晰评分、精确活检评分及结肠镜报告书写合格率比较,差异无统计学意义(P> 0.05)。结论基于虚拟仿真系统的PBL教学法在单人结肠镜培训中具有一定的优势,可提高学员的一部分操作评分及教学满意度。

Objective To investigate the effect of problem-based learning(PBL)based on virtual simulation system in single colonoscopy training.Methods From January 2018 to December 2021,a total of 84 gastroenterology resident doctors receiving standardized training(hereinafter referred to as"resident training"),clinical postgraduates and trainees majoring in gastroenterology were selected as the study subjects.According to the method of random number table,they were divided into experimental group and control group,with 42 resident doctors in each group.The experimental group adopted PBL teaching based on virtual simulation system,and the control group adopted traditional teaching.The theoretical assessment scores of the two groups after 2 weeks were compared,and the success rate,length,operation time,gobal assessment of gastrointestinal endoscopic skills-colonoscopy(GAGES-C)score,report writing pass rate and student satisfaction were compared after 12 weeks.Results The theoretical test scores and the pass rate of ileocecal entrance examination in experimental group were higher than those in control group,and the differences were statistically significant(P<0.05).The insertion length was shorter than that of the control group,and the difference was statistically significant(P<0.05);the operation time was shorter than that of the control group,and the difference was statistically significant(P<0.05);student satisfaction was higher than that of the control group, and the difference was statistically significant (P<0.05). In the GAGE-C score, the control score of endoscopic motion trajectory, the score of entrance technique, the score of overall proficiency and the total score of the experimental group [(4.1±0.4) points, (4.2±0.4) points, (4.3±0.3) points, (21.2±1.4) points] were higher than those of the control group [(3.8±0.5) points, (3.9±0.4) points, (3.9±0.3) points, (19.9±1.5) points], the difference was statistically significant (P<0.05). There was no significant difference in the score of endoscopic clear field, accurate biopsy score and the qualified rate of colonoscopy report writing between 2 groups (P>0.05). Conclusion The PBL teaching method with virtual simulation demonstrates certain advantages in single colonoscopy training, which can improve some of the students' operational scores and teaching satisfaction.