Wang Yun, Tian Hong, Li Jianyun, Zhou Chongzhi, Feng Yiwen, Li Jinbao, Huang Lina
Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University, No. 650, New Songjiang Road, Shanghai, 201620, China.
Shanghai Medical Doctor Association, No. 1477, West Beijing Road, Jing'an District, Shanghai, 200240, China.
BMC Med Educ. 2025 Mar 25;25(1):436. doi: 10.1186/s12909-025-07011-2.
While simulation is widely employed in anesthesia crisis management training, its effectiveness is often hindered by lack of preparation. Flipped classroom (FC) is a novel teaching method that encourages active student engagement and preparation. We aim to investigate whether FC could enhance the residents' engagement in preparation activities and improve the learning outcomes in anesthesia crisis management simulation.
This quasi-experimental study included anesthesiology residents from the anesthesiology department, Shanghai General Hospital between January 2023 and July 2023. The participants were randomly divided into the FC group and the conventional lecture (CL) group. The primary outcome was the Anesthetists' Non-Technical Skills (ANTS) scores of all participants. Secondary outcomes included crisis response performance, theoretical test scores, and time spent on training-related activities.
A total of 40 anesthesiology residents in their first two postgraduation years at Shanghai General Hospital were recruited for analysis. The FC group (n = 20) achieved significantly higher overall ANTS scores (FC vs. CL: 11.95 ± 2.14 vs. 9.55 ± 2.40, p = 0.002) than the CL group. The FC group had higher correct response rates in two out of six observational checkpoints in the simulation (FC vs. CL: 'Recognize acute pulmonary embolism and deal with it accordingly', 95% vs. 60%, p = 0.020; 'Provide circulatory support and heparin treatment', 100% vs. 75%, p = 0.047). The FC group also obtained higher post-training theoretical test scores (FC vs. CL: 90.9 ± 4.8 vs. 84.8 ± 7.8, p = 0.005) than the CL group. While the FC group spent more time studying before the simulation session (FC vs. CL (mean [min, max]): 2.6 [1.3, 3.6] vs. 1.3 [0.3, 2.3], p < 0.0001), there was no significant difference in total studying time between the two groups (FC vs. CL (mean [min, max]): 3.6 [2, 5.6] vs. 3.4 [1.8, 4.9], p = 0.418).
FC may improve the learning performance in the management of perioperative pulmonary embolism within anesthesia crisis management simulation training compared to CL-based learning.
The study was registered with No. ChiCTR2300070086.
虽然模拟在麻醉危机管理培训中被广泛应用，但其有效性常常因准备不足而受到阻碍。翻转课堂（FC）是一种新型教学方法，鼓励学生积极参与并做好准备。我们旨在研究翻转课堂是否能增强住院医师在准备活动中的参与度，并改善麻醉危机管理模拟中的学习效果。
这项准实验研究纳入了2023年1月至2023年7月期间上海交通大学医学院附属瑞金医院麻醉科的住院医师。参与者被随机分为翻转课堂组和传统讲座组。主要结局是所有参与者的麻醉医师非技术技能（ANTS）得分。次要结局包括危机应对表现、理论测试成绩以及在与培训相关活动上花费的时间。
共招募了40名上海交通大学医学院附属瑞金医院毕业后前两年的麻醉科住院医师进行分析。翻转课堂组（n = 20）的总体ANTS得分显著高于传统讲座组（FC组与CL组：11.95 ± 2.14 vs. 9.55 ± 2.40，p = 0.002）。在模拟的六个观察点中的两个，翻转课堂组有更高的正确反应率（FC组与CL组：“识别急性肺栓塞并相应处理”，95% vs. 60%，p = 0.020；“提供循环支持和肝素治疗”，100% vs. 75%，p = 0.047）。翻转课堂组的培训后理论测试成绩也高于传统讲座组（FC组与CL组：90.9 ± 4.8 vs. 84.8 ± 7.8，p = 0.005）。虽然翻转课堂组在模拟课程前花费更多时间学习（FC组与CL组（平均[最小值，最大值]）：2.6 [1.3, 3.6] vs. 1.3 [0.3, 2.3]，p < 0.0001），但两组之间的总学习时间没有显著差异（FC组与CL组（平均[最小值，最大值]）：3.6 [2, 5.6] vs. 3.4 [1.8, 4.9]，p = 0.418）。
与基于传统讲座的学习相比，翻转课堂可能会改善麻醉危机管理模拟培训中围手术期肺栓塞管理的学习表现。
该研究已在ChiCTR2300070086注册。
