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一种用于基础外科技能的新型临床模拟缝合教育:在固定于标准化患者身上的生物组织上进行缝合,并使用客观结构化技术技能评估(OSATS)工具进行评估。

A Novel Clinical-Simulated Suture Education for Basic Surgical Skill: Suture on the Biological Tissue Fixed on Standardized Patient Evaluated with Objective Structured Assessment of Technical Skill (OSATS) Tools.

作者信息

Shen Zhanlong, Yang Fan, Gao Pengji, Zeng Li, Jiang Guanchao, Wang Shan, Ye Yingjiang, Zhu Fengxue

机构信息

a Department of Gastroenterological Surgery, Laboratory of Surgical Oncology , Peking University People's Hospital , Beijing 100044 , PR China.

b Department of Thoracic Surgery , Peking University People's Hospital , Beijing , 100044 PR China.

出版信息

J Invest Surg. 2018 Aug;31(4):333-339. doi: 10.1080/08941939.2017.1319994. Epub 2017 Jun 21.

Abstract

BACKGROUND

Clinical-simulated training has shown benefit in the education of medical students. However, the role of clinical simulation for surgical basic skill training such as suturing techniques remains unclear.

MATERIALS AND METHODS

Forty-two medical students were asked to perform specific suturing tasks at three stations with the different settings within four minutes (Station 1: Synthetic suture pad fixed on the bench, Station 2: Synthetic suture pad fixed on the standardized patient, Station 3: Pig skin fixed on the standardized patient); the OSATS (Objective Structured Assessment of Technical Skill) tool was used to evaluate the performance of students. A questionnaire was distributed to the students following the examination.

RESULTS

Mean performance score of Station 3 was significant lower than that of Station 1 and 2 in the general performance including tissue handling, time, and motion. The suturing techniques of students at Station 2 and 3 were not as accurate as that at Station 1. Inappropriate tension was applied to the knot at Station 2 compared with Station 1 and 3. On the questionnaire, 93% of students considered clinical-simulated training of basic surgical skills was necessary and may increase their confidence in future clinical work as surgeons; 98% of students thought the assessment was more objective when OSATS tool was used for evaluation.

CONCLUSION

Clinical simulation examination assessed with OSATS might throw a novel light on the education of basic surgical skills and may be worthy of wider adoption in the surgical education of medical students.

摘要

背景

临床模拟训练已显示出对医学生教育有益。然而,临床模拟在外科技能训练如缝合技术方面的作用仍不明确。

材料与方法

42名医学生被要求在四个不同场景的站点在四分钟内完成特定的缝合任务(站点1:固定在实验台上的合成缝合垫;站点2:固定在标准化病人身上的合成缝合垫;站点3:固定在标准化病人身上的猪皮);使用OSATS(客观结构化技术技能评估)工具评估学生的表现。考试结束后向学生发放问卷。

结果

在包括组织处理、时间和动作的总体表现方面,站点3的平均表现得分显著低于站点1和站点2。站点2和站点3学生的缝合技术不如站点1准确。与站点1和站点3相比,站点2在打结时施加了不适当的张力。在问卷中,93%的学生认为外科技能基础的临床模拟训练是必要的,并且可能会增加他们未来作为外科医生从事临床工作的信心;98%的学生认为使用OSATS工具进行评估时,评估更客观。

结论

用OSATS评估的临床模拟考试可能为外科技能基础的教育提供新的思路,并且可能值得在医学生外科教育中更广泛地采用。

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