Department of Cardiothoracic Surgery, St George's Hospital, London, United Kingdom.
Cardiothoracic Anesthesia, St George's Hospital, London, United Kingdom.
J Thorac Cardiovasc Surg. 2015 Jul;150(1):22-5. doi: 10.1016/j.jtcvs.2015.04.032. Epub 2015 Apr 23.
The Intercollegiate Surgical Curriculum now recommends that cardiac surgical trainees should be able to understand and interpret transesophageal echocardiography images. However, cardiac surgical trainees receive limited formal transesophageal echocardiography training. The objective of this study was to assess the impact of simulation-based teaching versus more traditional operating room teaching on transesophageal echocardiography knowledge in cardiac surgical trainees.
A total of 25 cardiac surgical trainees with no formal transesophageal echocardiography learning experience were randomly assigned by computer to a study group receiving simulation-based transesophageal echocardiography teaching via the Heartworks (Inventive Medical, London, UK) simulator (n = 12) or a control group receiving transesophageal echocardiography teaching during elective cardiac surgery (n = 13). Each subject undertook a video-based test composed of 20 multiple choice questions on standard transesophageal echocardiography views before and after teaching.
There was no significant difference in the pretest scores between the 2 groups (P = .89). After transesophageal echocardiography teaching, subjects within each group demonstrated a statistically significant improvement in transesophageal echocardiography knowledge. Although the subjects within the simulation group outperformed their counterparts in the operating room teaching group in the post-test scores, this difference was not significant (P = .14).
Despite the familiarity with transesophageal echocardiography images during surgery, subjects in the simulation group performed at least as well as those in the operating room group. Surgical trainees will benefit from formal transesophageal echocardiography teaching incorporated into their training via either learning method.
现在，大学间外科学课程建议心脏外科受训者应能够理解和解释经食管超声心动图图像。然而，心脏外科受训者接受的经食管超声心动图培训有限。本研究的目的是评估基于模拟的教学与更传统的手术室教学对心脏外科受训者经食管超声心动图知识的影响。
共有 25 名没有接受过正式经食管超声心动图学习经验的心脏外科受训者通过计算机被随机分配到研究组，通过 Heartworks（伦敦Inventive Medical 公司）模拟器接受基于模拟的经食管超声心动图教学（n = 12）或对照组，在选择性心脏手术期间接受经食管超声心动图教学（n = 13）。每个受试者在教学前后进行了一项基于视频的测试，该测试由 20 个关于标准经食管超声心动图视图的多项选择题组成。
两组的预测试成绩没有显著差异（P =.89）。在经食管超声心动图教学后，每个组内的受试者在经食管超声心动图知识方面都有统计学上的显著提高。尽管模拟组内的受试者在术后测试分数上优于手术室教学组内的受试者，但这一差异并不显著（P =.14）。
尽管在手术期间对经食管超声心动图图像已经熟悉，但模拟组的受试者表现至少与手术室组的受试者一样好。通过这两种学习方法之一，将正式的经食管超声心动图教学纳入其培训的外科受训者将受益。
