导航支气管镜技术与人工智能辅助在支气管镜基础技能培训中的实践与思考

Practice of navigation bronchoscopy and artificial intelligence in the basic navigational bronchoscopy skills and technique training

目的探讨导航支气管镜技术与人工智能在住院医师支气管镜基础技能规范化培训中的实践效果,以进一步提升住院医师的操作技能水平。方法选取2023年9月至2024年1月在上海交通大学医学院附属瑞金医院参加basic NBSTAT培训的26名学员为研究对象,其中包括住院医师规范化培训住院医师14名和专科医师规范化培训住院医师12名。培训采用以导航模式为核心设计理念的模块化课程,包括确定病灶、精确定位、路径规划、导航操作和实时纠错5个模块,并结合理论授课和实践操作。教学评价采用瑞金医院气管内镜模拟训练系统和电磁导航支气管镜系统进行模拟操作考核,评价学员的操作熟练度。使用SPSS 26.0软件行统计分析,运用t检验和Wilcoxon秩和检验进行差异显著性分析。结果培训后,所有学员的操作技能均显著提升,模拟操作时间从(125.08±48.16)s缩至(77.69±24.75)s,失误次数从1次降至0次,总评分从(60.77±15.01)分提高至(75.19±17.63)分,导航操作时间从3(3,4)min降至2(2,3)min,差异均有统计学意义;住培医师及专培医师成绩差异无统计学意义。学员对培训的总体满意率达100.00%。结论该培训课程在支气管镜基础技能培训中的实践效果显著,能够有效提升各类住院医师的支气管镜操作技能,是应对肺部疾病诊疗技术不断进步的有效途径。

Objective To investigate the effects of navigation bronchoscopy and artificial intelligence in the standardized training of residents on basic bronchoscopy skills,with the goal of enhancing their practical abilities.Methods We selected 26 trainees(14 on standardized training of residents and 12 on standardized training of specialists)who participated in the basic navigational bronchoscopy skills and technique training(NBSTAT)at Ruijin Hospital,Shanghai Jiao Tong University School of Medicine from September 2023 to January 2024.The training was structured around a modular curriculum with navigation as the core design concept,consisting of five modules:lesion identification,precise localization,route planning,navigation operation,and real-time error correction.Theoretical teaching and skill practice were combined.The skill proficiency of the trainees was assessed using the Ruijin Hospital bronchoscopy simulation training system and the electromagnetic navigation bronchoscopy system.SPSS 26.0 was used to perform the t-test and Wilcoxon rank-sum test for comparisons.Results After the training,the trainees as a whole showed significant improvements in practicing the skills,with the simulated operation time was reduced from(125.08±48.16)seconds to(77.69±24.75)seconds,the number of errors decreased from 1 to 0,the total score increased from(60.77±15.01)to(75.19±17.63),and the navigation operation time was reduced from 3(3,4)minutes to 2(2,3)minutes(all P<0.05).There were no significant differences in these assessment items between resident trainees and specialist trainees.The satisfaction rate of the trainees with the training reached 100.00%.Conclusions The curriculum is effective in basic bronchoscopy skill training,remarkably enhancing the bronchoscopy skills of resident and specialist physicians,which is a useful approach for physicians to cope with the continuous development of diagnostic and therapeutic techniques for pulmonary diseases.