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基础开放手术技能模拟训练中二元组练习的挑战——一项混合方法研究

The Challenges of Dyad Practice in Simulation Training of Basic Open Surgical Skills-A Mixed-Method Study.

作者信息

Zetner Diana B, Konge Lars, Fabrin Anja, Christensen John B, Thinggaard Ebbe

机构信息

From the Copenhagen Academy for Medical Education and Simulation (D.B.Z., L.K., A.F., J.B.C., E.T.), Copenhagen Ø; University of Copenhagen, Faculty of Health and Medical Sciences (L.K.), Copenhagen N; Department of Thoracic, Cardiac and Vascular Surgery (A.F.), Odense University Hospital, Odense; and Department of Obstetrics and Gynaecology, Slagelse Sygehus (E.T.), Slagelse, Denmark.

出版信息

Simul Healthc. 2022 Feb 1;17(1):e91-e97. doi: 10.1097/SIH.0000000000000560.

Abstract

INTRODUCTION

Simulation training at home improves access to training, but motivation can be difficult to maintain. Dyad training could keep trainees motivated. This study aimed to examine the effect of self-regulated training of basic surgical skills in pairs versus individually.

METHODS

One hundred one medical doctors were included in this prospective, mixed-method, simulation-based study. Participants were randomized to train individually or in pairs during a 6-week course in open surgical skills, consisting of didactic instructions and self-directed training at home. Trainees kept a training log and filled in a questionnaire. Skills were tested before and after the course. Tests were rated by an expert using the Objective Structured Assessment of Technical Skills Global Rating Scale.

RESULTS

Ninety-seven doctors completed the study. We found no differences in test score between dyad and individual trainees. Dyad trainees compared with individual trainees improved by 7.23 points (intercept estimate) versus 6.94 points, respectively (P = 0.881). Dyad trainees trained less frequently [7.3 times (intercept estimate) vs. 12.1 times, P < 0.001, but for longer intervals compared with individual trainees (68 minutes vs. 38 minutes)]. Dyad trainees reported benefits such as having a sparring partner, receiving feedback, corrections, increased motivation, having fun, and more structured training sessions. However, the coordination of training sessions was difficult.

CONCLUSIONS

No differences were found between dyad trainees and individual trainees in improvement of surgical skills. Off-site dyad training led to fewer, but longer training sessions, which may have negatively impacted the effectiveness of training. Dyad trainees perceived dyad training beneficial.

摘要

引言

在家进行模拟训练可增加训练机会,但难以保持积极性。双人训练可使学员保持动力。本研究旨在探讨基础外科手术技能的自我调节式双人训练与单人训练的效果。

方法

本项前瞻性、混合方法、基于模拟的研究纳入了101名医生。参与者被随机分配在为期6周的开放手术技能课程中进行单人训练或双人训练,该课程包括理论指导和在家自主训练。学员记录训练日志并填写问卷。在课程前后对技能进行测试。由一名专家使用客观结构化技术技能评估全球评分量表对测试进行评分。

结果

97名医生完成了研究。我们发现双人训练学员和单人训练学员的测试分数没有差异。双人训练学员与单人训练学员相比,分别提高了7.23分(截距估计值)和6.94分(P = 0.881)。双人训练学员训练频率较低[7.3次(截距估计值)对12.1次,P < 0.001],但与单人训练学员相比训练时间间隔更长(68分钟对38分钟)。双人训练学员报告了一些好处,如拥有一个陪练伙伴、获得反馈、得到纠正、动力增加、享受乐趣以及训练课程更有条理。然而,训练课程的协调很困难。

结论

在手术技能提高方面,双人训练学员和单人训练学员之间未发现差异。场外双人训练导致训练次数减少,但训练时间延长,这可能对训练效果产生了负面影响。双人训练学员认为双人训练有益。

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