Patel R, Dennick R
Nottingham University Hospitals, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK.
University of Nottingham, Medical School, Nottingham NG7 2UH, UK.
Clin Radiol. 2017 Mar;72(3):266.e7-266.e14. doi: 10.1016/j.crad.2016.10.014. Epub 2016 Dec 13.
To establish the educational effectiveness of simulation teaching in interventional radiology training.
Electronic databases (MEDLINE, ERIC, Embase, OvidSP, and Cochrane Library) were searched (January 2000 to May 2015). Studies specifically with educational outcomes conducted on radiologists were eligible. All forms of simulation in interventional training were included. Data were extracted based on the population, intervention, comparison, and outcome (PICO) model. Kirkpatrick's hierarchy was used to establish educational intervention effectiveness. The quality of studies was assessed using the Cochrane risk of bias tool.
Search resulted in 377 articles, of which 15 met the inclusion criteria. Thirteen of the 15 studies achieved level 2 of Kirkpatrick's hierarchy with only one reaching level 4. Statistically significant improvements in performance metrics as objective measures, demonstrating trainee competence were seen in 12/15 studies. Subjective improvements in confidence were noted in 13/15. Only one study demonstrated skills transferability and improvements in patient outcomes.
Results demonstrate the relevance of simulated training to current education models in improving trainee competence; however, this is limited to the simulated environment as there is a lack of literature investigating its predictive validity and the effect on patient outcomes. The requirement for further research in this field is highlighted. Simulation is thus currently only deemed useful as an adjunct to current training models with the potential to play an influential role in the future of the interventional radiology training curriculum.
确立模拟教学在介入放射学培训中的教育效果。
检索电子数据库（MEDLINE、ERIC、Embase、OvidSP和Cochrane图书馆）（2000年1月至2015年5月）。纳入专门针对放射科医生进行的具有教育成果的研究。介入培训中的所有模拟形式均包括在内。根据人群、干预措施、对照和结果（PICO）模型提取数据。使用柯克帕特里克层次模型来确立教育干预效果。采用Cochrane偏倚风险工具评估研究质量。
检索得到377篇文章，其中15篇符合纳入标准。15项研究中有13项达到了柯克帕特里克层次模型的2级，只有1项达到4级。在12/15的研究中，作为客观指标的绩效指标有统计学意义的改善，表明学员能力有所提高。13/15的研究中提到了信心方面的主观改善。只有1项研究证明了技能的可转移性以及患者结局的改善。
结果表明模拟培训与当前教育模式在提高学员能力方面具有相关性；然而，这仅限于模拟环境，因为缺乏研究其预测效度以及对患者结局影响的文献。突出了该领域进一步研究的必要性。因此，目前模拟仅被视为当前培训模式的辅助手段，有可能在介入放射学培训课程的未来发挥重要作用。
