Division of Cardiovascular Surgery, Mayo Clinic and Foundation, 200 First St SW, Rochester, MN 55905, USA.
J Thorac Cardiovasc Surg. 2010 Mar;139(3):707-12. doi: 10.1016/j.jtcvs.2009.10.029. Epub 2009 Dec 28.
We developed and tested a clinical simulation program in the principles and conduct of cardiopulmonary bypass with the aim of improving confidence and proficiency in this critical aspect of cardiac surgical care.
Fifteen residents from 6 resident-training programs who reported no prior cardiopulmonary bypass observation or simulation-based perfusion experience participated in a cardiopulmonary bypass course involving both didactic lectures and hands-on simulation. A computer-controlled hydraulic model of the human circulation was used in a specifically designed multidisciplinary simulation center environment to give the participants hands-on training with both basic operations and specific perfusion crisis scenarios. Pretraining and posttraining assessments concerning confidence, knowledge, and applications with regard to cardiopulmonary bypass were administered and compared.
Likert scale scores on confidence-related items increased significantly (P < .001), from 59% +/- 16% to 92% +/- 8%. Pretraining versus posttraining scores (72% +/- 14%) on similar cognitive items were not significantly different (P=.3636). Scores on similar open-ended application items before and after training improved from 62% +/- 25% to 85+/-10% (P < .0001). All subjects agreed that simulation-based cardiopulmonary bypass training was superior to classroom- and clinic-based education and that the scenarios enhanced their learning experience.
Simulation-based cardiopulmonary bypass training appears to be an effective technique to build the confidence of thoracic surgery residents regarding knowledge and applications. Scenario-based practice in a specifically designed simulated environment is a valuable adjunct to traditional educational methods and has the potential to improve the training of thoracic residents.
我们开发并测试了一种心肺转流术原则和操作的临床模拟项目，旨在提高心脏外科护理中这一关键方面的信心和熟练度。
来自 6 个住院医师培训项目的 15 名住院医师报告说他们没有心肺转流术观察或基于模拟的灌注经验，他们参加了一个心肺转流术课程，包括理论讲座和实践模拟。在专门设计的多学科模拟中心环境中，使用了一个计算机控制的人体循环液压模型，为参与者提供了基本操作和特定灌注危机场景的实践培训。进行了心肺转流术相关信心、知识和应用的预培训和后培训评估，并进行了比较。
信心相关项目的李克特量表评分显著增加（P<0.001），从 59%±16%增加到 92%±8%。类似认知项目的预培训与后培训评分（72%±14%）无显著差异（P=0.3636）。培训前后类似开放式应用项目的评分从 62%±25%提高到 85%±10%（P<0.0001）。所有受试者都认为基于模拟的心肺转流术培训优于课堂和临床教育，并且情景增强了他们的学习体验。
基于模拟的心肺转流术培训似乎是一种有效的技术，可以增强胸外科住院医师在知识和应用方面的信心。在专门设计的模拟环境中进行基于情景的实践是传统教育方法的有价值的补充，并有潜力提高胸科住院医师的培训效果。
