Hospital das Clínicas from University of São Paulo, São Paulo, Brazil.
Hospital das Clínicas from University of São Paulo, São Paulo, Brazil.
J Surg Res. 2022 Oct;278:240-246. doi: 10.1016/j.jss.2022.02.033. Epub 2022 May 26.
The lack of standardized skill training reported by medical students in performing tube thoracostomies may be associated with higher complications. The ideal training model is yet to be determined. This study sought to evaluate three different models.
Between 2015 and 2017, 204 last-year medical students of Universidade de São Paulo with no prior training in tube thoracostomy were randomized into three groups: cadaver, pig, and synthetic models. All groups performed 1-d tube thoracostomy hands-on training and a 40-min theoretical class. The knowledge acquisition was measured by a comparison between a theoretical test before and 3 wk after the class, and the skills improvement was evaluated by a comparison between the skills test on the same day of the hands-on training and another after 24 wk (the retention skill test). A questionnaire was submitted to evaluate their satisfaction rate and self-reported confidence, as per a Likert scale.
The theoretical post-test score was higher compared to the pretest score in all groups (P < 0.001). The retention skills test in the cadaver and synthetic groups decreased compared to the skills test (P = 0.01 and P = 0.007, respectively). There was no difference between the groups either in the theoretical test or in the skills test. Student satisfaction was higher in the cadaver and pig groups. The confidence perception increased in all groups after the training.
The models used for tube thoracostomy training appear to have a similar impact on skills retention, knowledge acquisition, and confidence. Although the satisfaction rate is lower for the synthetic model, it has no biological risk or ethical issues and is more feasible.
据报道，医学生在进行胸腔引流管置管术时缺乏标准化的技能培训，这可能与更高的并发症发生率有关。目前还没有确定理想的培训模式。本研究旨在评估三种不同的模式。
在 2015 年至 2017 年期间，随机将 204 名来自圣保罗大学、没有胸腔引流管置管术培训经验的最后一年医学生分为三组：尸体组、猪组和合成模型组。所有组均接受 1 天的胸腔引流管置管术实践培训和 40 分钟的理论课程。通过比较理论测试前和课程结束后 3 周的理论测试，以及实践培训当天的技能测试和 24 周后的保留技能测试（保留技能测试），来评估知识获取情况。通过李克特量表向学生发放问卷，评估他们的满意度和自我报告的信心。
所有组的理论后测得分均高于前测得分（P<0.001）。尸体组和合成组的保留技能测试得分较技能测试得分下降（P=0.01 和 P=0.007）。各组之间的理论测试或技能测试均无差异。尸体组和猪组的学生满意度较高。培训后，所有组的信心感知均有所提高。
用于胸腔引流管置管术培训的模型似乎对技能保留、知识获取和信心具有相似的影响。尽管合成模型的满意度较低，但它没有生物风险或伦理问题，并且更具可行性。
