Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Eight-Year Program of Clinical Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Int J Gynaecol Obstet. 2018 May;141(2):255-260. doi: 10.1002/ijgo.12404. Epub 2017 Dec 22.
To estimate whether different numbers of simulation training models affect medical students' cervical examination performance.
In a prospective study at Peking Union Medical College Hospital, Beijing, China, between August 1, 2016, and April 30, 2017, fifth-year medical students without obstetric experience were randomly assigned to the large or small number training groups. Participants in the large number group performed cervical examinations on 10 dilation models and nine effacement/consistency models; those in the small number group practiced on four dilation models and three effacement/consistency models. In the examination, both groups evaluated 10 models in the same sequence and reported findings. Participants also completed confidence surveys. Mann-Whitney U test was used to compare the assessment accuracy and confidence improvement between the groups.
There were 91 students randomized to the large (n=45) or small (n=46) number training groups. As compared with the small number group, the large number group demonstrated higher accuracy in assessing exact dilation (P=0.028), exact effacement (P=0.002), effacement within 0.5 cm (P=0.017), and consistency (P=0.045). There was no difference in assessing dilation within 1 cm or in confidence improvement between the groups.
A small number of simulation training models was sufficient to improve students' accuracy and confidence in assessing cervical dilatation, although a large number was needed to improve accuracy in cervical effacement and consistency.
评估模拟训练模型数量的不同是否会影响医学生的宫颈检查表现。
在中国北京协和医学院医院进行的一项前瞻性研究中，2016 年 8 月 1 日至 2017 年 4 月 30 日，没有产科经验的五年级医学生被随机分配到模型数量多的组或模型数量少的组。数量多的组的参与者在 10 个扩张模型和 9 个消退/一致性模型上进行宫颈检查；数量少的组在 4 个扩张模型和 3 个消退/一致性模型上进行练习。在检查中，两组以相同的顺序评估 10 个模型，并报告发现。参与者还完成了信心调查。使用 Mann-Whitney U 检验比较两组之间评估准确性和信心提高的差异。
91 名学生被随机分配到模型数量多（n=45）或模型数量少（n=46）的组。与模型数量少的组相比，模型数量多的组在评估准确扩张（P=0.028）、准确消退（P=0.002）、消退在 0.5 cm 以内（P=0.017）和一致性（P=0.045）方面的准确性更高。在评估 1 cm 以内的扩张或两组之间的信心提高方面，没有差异。
少量模拟训练模型足以提高学生评估宫颈扩张的准确性和信心，尽管需要大量模型才能提高宫颈消退和一致性的准确性。
