三维计算机辅助解剖教学在住院医师规范化培训中的应用

The Application of the 3-Demensional Computer Assisted Instruction Model for Teaching Anatomy in the Standardized Training Practice for Residents

目的探索三维计算机辅助(3-demensional computer assisted instruction,3D CAI)颞骨解剖教学在住院医师规范化培训中的应用。方法回顾性分析2018年1月—2023年1月于西安交通大学第二附属医院耳科学专业进行住院医师规范化培训的58名学员,按照参加培训的时间将其分为试验组和对照组。2018年1月—2020年12月的23名住院医师作为对照组,2021年1月—2023年12月的35名住院医师作为试验组,分别采用传统教学方法和3D CAI进行颞骨解剖授课和培训。结束后,分别对2组医师进行解剖名词(中耳、内耳、侧颅底)、解剖空间方位、解剖标志认识和颞骨CT阅片能力测试,并对教学方法、教学内容的满意度进行问卷调查。在学习前后对2组进行自信心评价评,即是否颞骨解剖结构不易理解、是否有信心辨识颞骨解剖结构。比较2组医生的测试成绩、对教学的满意度以及学习自信心。结果试验组医师的中耳和内耳解剖测试成绩与对照组比较,差异无统计学意义(P>0.05)。试验组在侧颅底解剖、解剖空间方位、解剖标志认识、颞骨CT阅片成绩分别为7(7,8)、8(7,8)、8(7,9)和(82.12±8.37)分,均高于对照组[5(5,6),5(5,6),6(6,7)和(74.65±7.96)分](P<0.05)。试验组对教学内容的满意度为85.71%,对教学方法的满意度为91.43%,高于对照组对教学内容和教学方法的满意度(60.87%和65.22%)(P<0.05)。经过学习,试验组有62.86%的医师认为颞骨解剖容易记忆和理解,71.43%的医师认为有信心辨识出颞骨解剖结构,均高于对照组(34.78%和4.38%)(P<0.05)。结论3D CAI颞骨解剖教学内容新颖,可激发学员的学习兴趣和信心,减少其对晦涩的解剖知识的抵触和恐惧,有助于提高耳科住院医师规范化培训的效率。

Objective To explore the application of 3-Demensional Computer Assisted Instruction(3D CAI)model for teaching temporal bone anatomy in the standardized training practice for otological residents.Methods A total of 58 trainees were selected in the Department of Otolaryngology-Head and Neck Surgery,the Second Affiliated Hospital of Xi'an Jiaotong University from January 2018 to December 2023.They were divided into control group and experimental group according to the time of participating in regular training.From January 2018 to December 2020,23 residents served as control group.From January 2021 to December 2023,35 residents were in the experimental group.The temporal bone anatomy was taught with 3D CAI model and traditional teaching methods respectively.The theory examination of middle ear anatomy,inner ear anatomy,lateral skull base anatomy,anatomical orientation and anatomical landmarks and temporal bone CT film reading test will be held at the end of the otology training.The self-confidence of temporal bone anatomy learning was evaluated by the trainees themselves that whether it is easy for them to recognize the temporal bone structures and whether they have the confidence to recognize these structures.The satisfaction of teaching methods and contents was investigated by questionnaire after otology training.The differences of the two groups'scores and the evaluation of the questionnaire were compared.Results At the end of otological training,there are no significant differences in the scores of middle ear anatomy and inner ear anatomy between two groups(P<0.05).The scores of lateral skull base anatomy,the scores of anatomical orientation and anatomical landmarks,the scores of temporal bone CT examination in the experimental group were 7(7,8),8(7,8),8(7,9)and(82.12±8.37)points respectively,significantly better than those in the control group[5(5,6),5(5,6),6(6,7)and(74.65±7.96)points](P<0.05).The residents'satisfaction with teaching contents and teaching methods in the experimental group was 85.71%and 91.43%respectively,which were significantly higher than those in the control group(60.87%and 65.22%)(P<0.05).After learning the temporal bone anatomy practice course,62.86%of the residents in the experimental group thought that the temporal bone anatomy was easy to understand and memorize,and 71.43%of the residents in the experimental group could confidently identify the temporal bone anatomical structure,which were significantly higher than those of the control group(34.78%and 4.38%)(P<0.05).Conclusion 3D CAI model is attractive for teaching temporal bone anatomy in the standardized training practice for otological residents.It can stimulate interest and confidence of residents in learning and improve their teaching efficiency in the standardized training practice.