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[基于模拟训练对提高介入心脏病学手术初学者技能的优势:一项突尼斯横断面研究]

[Advantages of simulation-based training in improving skills of beginners in interventional cardiology procedures: a Tunisian cross-sectional study].

作者信息

Hammami Rania, Jdidi Jihen, Bahloul Amine, Ellouze Tarek, Kmiha Sahar, Haddar Oussema, Abdelmoula Yacine, Hassine Majed, Dammak Aymen, Charfeddine Selma, Billah Oueslati Mootaz, Dhaou Mahdi Ben, Abid Leila

机构信息

Service de Cardiologie, Centre Hospitalier Universitaire Hedi Chaker, Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie.

Centre de Simulation de la Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie.

出版信息

Pan Afr Med J. 2023 Dec 28;46:119. doi: 10.11604/pamj.2023.46.119.36874. eCollection 2023.

Abstract

INTRODUCTION

simulator training in interventional cardiology (ST) is an educational tool that is rapidly spreading worldwide. The purpose of this study was to evaluate the advantages of ST in improving skills of beginners in interventional cardiology procedures, through a short training cycle.

METHODS

we conducted a before-and-after quasi-experimental evaluative study in the simulation center of the Faculty of Medicine in Sfax. We involved cardiology residents at the beginning of their training in interventional cardiology. All the participants attended a 4-hour training course on a Cathi, high-fidelity simulator, after giving their consent. The primary endpoint was a significant improvement in performance and competence scores before and after the course. The secondary endpoint was the reduction in irradiation time and the time of the procedure.

RESULTS

thirteen learners participated in our study. The performance score improved by a median of 216.12% (ISQ = 285%). This improvement was significantly greater for learners who had never had access to the catheterisation room. The performance score ranged from a median of 31 (ISQ=40.5) to a median of 120 (ISQ=19.7), (p=0.001). The competence score for coronary angiography improved significantly, from a median of 16 (ISQ=18) to a median of 70 (ISQ=6), (p=0.001). The competence score for angioplasty improved significantly from a median of 10 (ISQ=17) to a median of 50 (ISQ=13.7), p=0.001. Procedure time of coronary angiography and angioplasty were significantly shortened from 12 min (ISQ=2) to 7 min (ISQ=1) after the simulation cycle (p=0.001), and from a median of 19 min to a median of 17 min after simulation, p=0.002.

CONCLUSION

despite a short-time simulation training, our pilot study demonstrates a significant improvement in the learners´ skills and performance, as well as a reduction in the time taken to carry out procedures and irradiation. This could eventually increase the number of procedures carried out daily in our cathlab and limit radiation exposure of staff and patients, while ensuring that the learners receive adequate training.

摘要

引言

介入心脏病学模拟训练(ST)是一种正在全球迅速普及的教育工具。本研究的目的是通过一个短期训练周期,评估ST在提高介入心脏病学手术初学者技能方面的优势。

方法

我们在斯法克斯医学院模拟中心进行了一项前后对照的准实验性评估研究。研究对象为刚开始介入心脏病学培训的心脏病学住院医师。所有参与者在签署知情同意书后,参加了为期4小时的关于Cathi高保真模拟器的培训课程。主要终点是课程前后操作和能力评分的显著提高。次要终点是减少照射时间和手术时间。

结果

13名学习者参与了我们的研究。操作评分中位数提高了216.12%(ISQ = 285%)。对于从未进入过导管室的学习者,这种提高更为显著。操作评分范围从中位数31(ISQ = 40.5)提高到中位数120(ISQ = 19.7),(p = 0.001)。冠状动脉造影的能力评分显著提高,从中位数16(ISQ = 18)提高到中位数70(ISQ = 6),(p = 0.001)。血管成形术的能力评分从中位数10(ISQ = 17)显著提高到中位数50(ISQ = 13.7),p = 0.001。模拟训练周期后,冠状动脉造影和血管成形术的手术时间从12分钟(ISQ = 2)显著缩短至7分钟(ISQ = 1),(p = 0.001),模拟训练后从中位数19分钟缩短至中位数17分钟,p = 0.002。

结论

尽管进行了短期模拟培训,但我们的初步研究表明,学习者的技能和操作有显著提高,同时手术时间和照射时间减少。这最终可能会增加我们导管室每天进行的手术数量,并限制工作人员和患者的辐射暴露,同时确保学习者接受充分的培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8dd/10924609/8bd12e38f378/PAMJ-46-119-g001.jpg

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