虚拟仿真关节镜模拟系统结合CBL在骨科临床教学中的应用

Application of virtual reality arthroscopic simulation system combined with case-based learning in orthopedic clinical teaching

目的探讨虚拟仿真关节镜模拟系统结合基于案例的学习(case-based learning,CBL)在骨科临床教学中的应用效果。方法选取2021年1月至2022年6月在苏州大学附属第三医院骨关节科进行住院医师规范化培训的36名学员作为教学对象,将其随机分为试验组和对照组,每组18名学员。试验组采用虚拟仿真关节镜模拟系统+CBL教学;对照组采用简易内镜模拟训练箱+传统授课方式。教学结束后,分别对两组学员进行理论考核、操作考核和问卷调查以评价教学效果。采用SPSS 22.0软件对两组计量资料进行t检验。结果试验组学员理论考核成绩([89.39±3.09)分]和操作考核成绩([82.72±4.28)分]均高于对照组([86.22±4.43)分和(76.61±5.65)分],差异均具有统计学意义(t=2.49,P=0.018;t=3.66,P=0.001)。问卷调查结果显示,两组学员对于教学效果的评价在课程形式的新颖性([4.94±0.24)分vs.(4.11±0.58)分,t=5.62,P<0.001]、场景模拟的真实度([4.83±0.38)分vs.(3.78±0.43)分,t=7.80,P<0.001]、学习兴趣及效率的提升([4.78±0.43)分vs.(4.00±0.59)分,t=4.51,P<0.001]、操作技能的提升([4.83±0.38)分vs.(3.83±0.51)分,t=6.61,P<0.001]和职业自信的建立([4.50±0.62)分vs.(3.06±0.54)分,t=7.47,均P<0.001]等5个方面试验组均优于对照组,且差异均具有统计学意义(均P<0.001)。结论虚拟仿真关节镜模拟系统结合CBL教学能高度模拟临床真实诊疗场景,有助于激发学员的学习兴趣,并快速提升其关节镜操作技能,从而增强临床教学效果。

Objective To evaluate the effect of virtual reality arthroscopic simulation system combined with case-based learning(CBL)in orthopedic clinical teaching.Methods From January 2021 to June 2022,a total of 36 residents who took the standardized residency training at Department of Articular Orthopedics in The Third Affiliated Hospital of Soochow University were enrolled in this study.They were randomized into an experimental group and a control group,with 18 trainees in each group.The experimental group adopted the virtual reality arthroscopic simulation system combined with CBL teaching mode,while the control group adopted simple endoscopic simulation training box with traditional teaching mode.Theoretical and practical tests and questionnaire survey were carried out to evaluate the teaching effects in two groups.SPSS 22.0 was performed to conduct t-test on the measurement data between the two groups.Results The theoretical and practical test scores of the experimental group[(89.39±3.09)and(82.72±4.28)]were better than those of the control group[(86.22±4.43)and(76.61±5.65)],with statistically significant differences(t=2.49,P=0.018;t=3.66,P=0.001).The questionnaire survey showed that the experimental group was better than the control group in creating novel forms of courses[(4.94±0.24)vs.(4.11±0.58),t=5.62,P<0.001],simulating more real scenes[(4.83±0.38)vs.(3.78±0.43),t=7.80,P<0.001],inspiring learning interests[(4.78±0.43)vs.(4.00±0.59),t=4.51,P<0.001],improving practical skills[(4.83±0.38)vs.(3.83±0.51),t=6.61,P<0.001],and building career confidence[(4.50±0.62)vs.(3.06±0.54),t=7.47,P<0.001],with statistically significant differences(all P<0.001).Conclusions The virtual reality arthroscopic simulation system combined with CBL teaching mode can better simulate the real clinical scenes,help inspire the interest of learning and quickly improve practical skills,thereby improving the effect of orthopedic clinical teaching.