SBML教学法在妇产科住院医师腹腔镜培训中的应用

Application of simulation-based mastery learning teaching method in laparoscopic training of obstetrics and gy⁃necology residents

目的评估基于仿真的掌握学习(SBML)教学法在妇产科住院医师腹腔镜培训中的应用效果。方法选择参加住院医师规范化培训的妇产科住院医师46名,采用基于SBML教学法对其进行多维度腹腔镜培训。培训内容包括理论知识教学和体外模拟箱模拟操作训练。采用客观评估工具比较培训前后住院医师的理论知识水平和腹腔镜操作技术水平。结果培训后,住院医师的理论考试成绩明显高于培训前,差异有统计学意义(t=17.16,P<0.05)。与培训前比较,在腹腔镜模拟箱缝合技能考核中,培训后住院医师完成夹球的平均时间和完成套圈的平均时间明显缩短(t分别=5.86、7.43,P均<0.05);在虚拟腹腔镜系统训练中,住院医师操作错误次数的腹腔镜缝合能力评估工具(LS-CAT)评分、持针缝合的LS-CAT评分降低,持针缝合的腹腔镜手术技巧整体评估系统(GOALS)评分明显提高(t分别=17.38、11.12、-19.31,P均<0.05)。结论基于SBML教学法在妇产科住院医师规范化培训中取得了明显的应用效果,能明显提高住院医师的腹腔镜操作理论知识水平和操作能力。

Objective To evaluate the effect of simulation-based mastery learning(SBML)teaching method in the laparoscopic training of obstetrics and gynecology residents.Methods Forty-six obstetrics and gynecology residents par⁃ticipating in the standardized training were selected and trained in multi-dimensional laparoscopy using the SBML teach⁃ing method.The training included theoretical knowledge teaching and extracorporeal simulation box operation training.Ob⁃jective assessment tools were used to compare the theoretical knowledge level and laparoscopic operation technical level of residents before and after training.Results After training,the theoretical examination scores of residents were signifi⁃cantly higher than those before training,and the difference was statistically significant(t=17.16,P<0.05).Compared with before training,in the assessment of laparoscopic simulation box suture skills,the average time to complete the ball clamping and the average time to complete the ring were significantly shortened after training(t=5.86,7.43,P<0.05).In the training of the virtual laparoscopic system,the LS-CAT score of operation errors of residents was significantly re⁃duced,the LS-CAT score of needle suture was decreased,while the GOALS score of needle suture operation were signifi⁃cantly improved(t=17.38,11.12,-19.31,P<0.05).Conclusion The SBML teaching method has achieved significant application effects in the standardized training of obstetrics and gynecology residents.The training method can obviously improve the theoretical knowledge level and operation ability of residents in laparoscopic operation.