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使用高保真度 3D 打印模型对新手住院医师进行基本鼻内镜技能培训。

Use of high-fidelity 3-dimensional-printed models for training novice residents in basic nasal endoscopic skills.

机构信息

Department of Rhinology, The ENT Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, China.

出版信息

Int Forum Allergy Rhinol. 2020 Dec;10(12):1309-1315. doi: 10.1002/alr.22601. Epub 2020 Jun 7.

Abstract

BACKGROUND

The use of 3-dimensional (3D)-printed models is promising in nasal endoscopic technique training. Here, we aimed to develop postsurgical simulants for use in conjunction with 3D-printed nasal models and to assess their usefulness in helping residents transfer basic endoscopic skills acquired during simulation training to clinical situations.

METHODS

The secretion simulant was prepared via a crosslinked reaction between sodium alginate and acrylamide, whereas the packing simulant was prepared using a superabsorbent polymer. After the simulants' fidelity and utility were evaluated by 5 rhinologists using a 5-point Likert scale, 46 novice residents were trained using the 3D-printed nasal models and postsurgical simulants for 2 weeks. A checklist and Global Rating Scale (GRS) were used to assess their performances before and after training, and the time to finish each task was also recorded. Following training, the qualified trainees operated on real patients and were reevaluated.

RESULTS

The simulants' similarity and usefulness scored ≥4.0, and the training cost was 28 CNY ($4 USD) per session. Following training, the checklist and GRS scores increased, and the operation time decreased (all p < 0.05). There were no statistical differences between the trainees' performances on the models with the simulants and on patients (all p > 0.05).

CONCLUSION

The low-cost simulated secretion and dressing are safe to use. The application of the simulants in conjunction with that of 3D-printed nasal models in a simulated task setting can help residents in transferring endoscopic skills acquired during simulation teaching to real patients.

摘要

背景

3 维(3D)打印模型在鼻内镜技术培训中具有应用前景。本研究旨在开发可与 3D 打印鼻模型一起使用的术后模拟物,并评估其在帮助住院医师将模拟训练中获得的基本内镜技能转移到临床实践中的作用。

方法

采用海藻酸钠和丙烯酰胺的交联反应制备分泌模拟物,采用高吸水性聚合物制备填充模拟物。5 名鼻科医生使用 5 分制 Likert 量表评估模拟物的逼真度和实用性后,46 名新手住院医师使用 3D 打印鼻模型和术后模拟物接受了为期 2 周的培训。使用检查表和总体评定量表(GRS)在培训前后评估他们的表现,并记录完成每个任务的时间。培训结束后,合格的受训者对真实患者进行操作,并重新进行评估。

结果

模拟物的逼真度和实用性评分均≥4.0,每次培训的成本为 28 元(4 美元)。培训后,检查表和 GRS 评分增加,手术时间缩短(均 P<0.05)。在模型上使用模拟物和在患者上使用模拟物的培训者表现之间无统计学差异(均 P>0.05)。

结论

低成本模拟分泌物和敷料安全实用。在模拟任务环境中,联合使用模拟物和 3D 打印鼻模型可帮助住院医师将模拟教学中获得的内镜技能转移到真实患者。

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