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基于正念训练对新手住院医师膝关节镜模拟训练技能表现的影响:一项随机对照研究。

Effect of Mindfulness Training on Skill Performance in Simulator-Based Knee Arthroscopy Training for Novice Residents-A Randomized Controlled Study.

机构信息

Department of Orthopedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China.

Department of Orthopedics, Fuyong People's Hospital, Shenzhen, China.

出版信息

J Surg Educ. 2024 Dec;81(12):103306. doi: 10.1016/j.jsurg.2024.103306. Epub 2024 Oct 29.

Abstract

OBJECTIVES

Negative emotions affect not only the physical health of residents but also the performance of surgical skills. Mindfulness training has been shown to be effective in improving mood. However, few studies have explored its effect on surgical skill performance. We aimed to investigate the effect of mindfulness training on knee arthroscopy skill performance.

DESIGN

We recruited 30 participants for knee arthroscopy skills training (Tasks 1-7) on a simulator, after which a pretest (Tasks 8 and 9) was conducted to test their skill performance and psychological states (including mindfulness state, anxiety, stress, and depression). Then, they were randomly assigned into 2 groups: the intervention group underwent 2 weeks of mindfulness training while the control group received no intervention. All participants were asked to retrain their skills 1 week after completing the initial arthroscopy skill training. After the 2-week mindfulness training intervention, a post-test was performed to detect the difference in skill performance and psychological states between 2 groups. We used the fNIRS device to record prefrontal cortex activation during the post-test.

SETTING

The study was carried out at the Zhujiang Hospital of Southern Medical University.

PARTICIPANTS

30 novice orthopedic residents.

RESULTS

A total of 30 residents completed all the study programs. We did not observe differences in arthroscopy skill performance at pretest. Compared with the control group, the intervention group showed significant improvement in total score of Task 8 (p = 0.034) and 9 (p = 0.002), as well as significant relief in anxiety (p = 0.037) and stress (p = 0.027) symptoms but no improvement in depression (p = 0.828). No statistical difference in 2 groups was observed on the activation of the left prefrontal cortex (p = 0.68).

CONCLUSIONS

Two weeks of mindfulness training can improve arthroscopy skill performance while alleviating anxiety and reducing stress in novice residents. Mindfulness training may be an effective adjunct to surgical skill training.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, Number: ChiCTR2200058144.

摘要

目的

负面情绪不仅会影响居民的身体健康,还会影响手术技能的表现。正念训练已被证明能有效改善情绪。然而,很少有研究探讨其对手术技能表现的影响。本研究旨在调查正念训练对膝关节镜手术技能表现的影响。

设计

我们招募了 30 名参与者进行膝关节镜技能训练(任务 1-7),在模拟器上进行,然后进行预测试(任务 8 和 9),以测试他们的技能表现和心理状态(包括正念状态、焦虑、压力和抑郁)。然后,他们被随机分为 2 组:干预组接受 2 周的正念训练,而对照组不接受干预。所有参与者在完成初始膝关节镜技能训练后 1 周被要求重新训练他们的技能。在 2 周的正念训练干预后,进行后测以检测 2 组之间技能表现和心理状态的差异。我们使用 fNIRS 设备记录后测期间前额叶皮层的激活。

地点

本研究在南方医科大学珠江医院进行。

参与者

30 名新手骨科住院医师。

结果

共有 30 名住院医师完成了所有研究项目。我们在前测中没有观察到膝关节镜技能表现的差异。与对照组相比,干预组在任务 8(p=0.034)和任务 9(p=0.002)的总分上有显著改善,以及焦虑(p=0.037)和压力(p=0.027)症状的显著缓解,但抑郁(p=0.828)没有改善。在左前额叶皮层的激活方面,2 组之间没有统计学差异(p=0.68)。

结论

2 周的正念训练可以提高新手住院医师的膝关节镜手术技能表现,同时减轻焦虑和降低压力。正念训练可能是手术技能训练的有效辅助手段。

试验注册

中国临床试验注册中心,编号:ChiCTR2200058144。

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