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在医学毕业期间通过指导教师培训获得缝合技能:一项比较高年级医学生和外科教员的随机对照研究。

Acquisition of suture skills during medical graduation by instructor-directed training: a randomized controlled study comparing senior medical students and faculty surgeons.

机构信息

Institute of Plastic and Craniofacial Surgery, Brazilian Society of Research and Assistance to Craniofacial Rehabilitation Hospital, Campinas, Brazil.

出版信息

Updates Surg. 2013 Jun;65(2):131-40. doi: 10.1007/s13304-013-0199-y. Epub 2013 Feb 13.

Abstract

Due to shortage of time and limited availability of faculty surgeons to teach basic surgical skills during medical graduation, the search for alternative ways of simulated training with feedback is needed. The purpose of this study was to compare the simulated teaching of suture skills to novice medical students by senior medical students and by experienced faculty surgeons. Forty-eight novice medical students were randomly assigned to three practice conditions on bench model (n = 16): self-directed suture training (control), senior medical student-directed suture skills' training, or experienced faculty surgeon-directed suture skills' training. Pre- and post-tests were applied. Global Rating Scale with blinded evaluation and self-perceived confidence based on Likert scale were used to assess all suture performances in pre- and post-training. Effect size was also calculated. The analysis made after training showed that the students who received feedback from the instructors had better performance based on the Global Rating Scale (all p < 0.0000) and felt more confident to carry out sutures (all p < 0.0000) when compared to the control. There was no significant difference (all p > 0.05) between the student-directed teaching and faculty-directed teaching groups. The magnitude of the effect (instructor-directed training suture) was considered large (>0.80) in all measurements. The acquisition of suture skills after student-directed training was similar to the training supervised by faculty surgeon, and the increase in suture performances of trainees that received instructor administered training was superior to self-directed learning.

摘要

由于时间紧张,以及可供教学的外科医师有限,难以在医学毕业阶段教授基本的外科技能,因此需要寻找替代方法,利用模拟训练和反馈来实现。本研究旨在比较由高年资医学生和经验丰富的外科教员指导新手医学生进行缝合技能模拟教学的效果。48 名新手医学生被随机分配到三种在模型上进行的练习条件(n=16):自我指导的缝合训练(对照组)、高年资医学生指导的缝合技能训练,或经验丰富的外科教员指导的缝合技能训练。在培训前后都进行了测试。采用盲法评估的综合评定量表和基于李克特量表的自我感知信心来评估培训前后的所有缝合表现。还计算了效应量。培训后的分析表明,与对照组相比,接受教员反馈的学生在综合评定量表上的表现更好(所有 p<0.0000),并且在进行缝合时更有信心(所有 p<0.0000)。学生指导教学组和教员指导教学组之间没有显著差异(所有 p>0.05)。在所有测量中,效果量(教员指导的缝合训练)都被认为很大(>0.80)。在学生指导训练后,缝合技能的获得与教员监督的训练相似,接受教员指导的培训的学员缝合表现的提高优于自我指导学习。

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