Smelt Jeremy L C, Phillips Simon, Hamilton Colin, Fricker Paul, Spray Dominic, Nowell Justin L, Jahangiri Marjan
Department of Cardiothoracic Surgery, St. George's Hospital, London, United Kingdom.
Department of Perfusion, St. George's Hospital, London, United Kingdom.
J Surg Educ. 2016 Nov-Dec;73(6):1026-1031. doi: 10.1016/j.jsurg.2016.05.009. Epub 2016 Jun 16.
Complications of cardiopulmonary bypass (CPB) are rare, but life-threatening events that need prompt and rehearsed actions involving a team. This is not adequately taught to cardiothoracic surgical trainees. The objective of this study was to assess the knowledge of cardiothoracic trainees required to manage these events after simulation-based vs. lecture-based teaching.
Totally, 17 cardiac surgical trainees with no formal teaching in intraoperative complications of CPB management were randomly assigned by computer to either a study group receiving simulation-based complications of CPB teaching via the Orpheus simulator (n = 9) or a control group receiving complications of CPB teaching via a lecture (n = 8). Each subject undertook a written test comprising 20 multiple choice questions on complications of CPB before and after teaching. Trainees were then asked to rate their satisfaction with each session from 1 to 5, with 5 being most satisfied.
St George Simulation and Clinical Skills Laboratory, St George's Hospital, London.
There was no significant difference in the pretest scores between the 2 groups (p = 0.29). After teaching, both groups showed a statistically significant improvement in their knowledge (p < 0.05). The trainees in the simulation group performed better than the lecture-based group; however, this was not statistically significant (p = 0.21). Satisfaction levels in both the lecture session and the simulation session were very high with means of 4.4/5 and 4.8/5, respectively.
Despite the familiarity with CPB during surgery, the simulation group performed at least as well as the lecture group. Cardiothoracic trainees would benefit from formal teaching of complications of CPB management via either learning modality being incorporated into their training.
体外循环（CPB）的并发症虽罕见，但却是危及生命的事件，需要团队迅速采取预先演练的行动。心胸外科手术实习生并未得到关于这方面的充分培训。本研究的目的是评估在基于模拟教学与基于讲座教学后，心胸外科实习生处理这些事件所需的知识。
共有17名未接受过CPB术中并发症正规教学的心脏外科实习生通过计算机随机分为研究组（n = 9），接受通过俄耳甫斯模拟器进行的基于模拟的CPB并发症教学，或对照组（n = 8），接受通过讲座进行的CPB并发症教学。每位受试者在教学前后都进行了一次包含20道关于CPB并发症的选择题的书面测试。然后要求实习生对每个课程从1到5进行满意度评分，5分为最满意。
伦敦圣乔治医院圣乔治模拟与临床技能实验室。
两组的预测试成绩无显著差异（p = 0.29）。教学后，两组的知识水平均有统计学意义上的显著提高（p < 0.05）。模拟组的实习生表现优于讲座组；然而，这并无统计学意义（p = 0.21）。讲座课程和模拟课程的满意度都非常高，平均分分别为4.4/5和4.8/5。
尽管手术中对CPB较为熟悉，但模拟组的表现至少与讲座组一样好。心胸外科实习生通过将这两种学习方式纳入其培训中，接受CPB管理并发症的正规教学将从中受益。
