Rattanalert Narisa, Tengtrisorn Supaporn, Wongwai Phanthipha, Wiwatwongwana Atchareeya, Singha Penny, Suwannaraj Sirinya, Jiwanarom Thunyaluck, Phanphruk Warachaya, Damthongsuk Parichat, Balmer Dorene F
Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
PLoS One. 2025 May 29;20(5):e0323365. doi: 10.1371/journal.pone.0323365. eCollection 2025.
Skills and confidence in performing high-risk procedures are essential for ensuring safe patient care. Deliberate practice is an instructional model designed to improve performance by engaging trainees in structured, repetitive practice with immediate feedback provided by supervisors. We developed a multifaceted simulation informed by deliberate practice and tested the hypothesis that trainee skills and reported confidence would increase after training. A multicenter prospective study was conducted at three universities in Thailand from July 1, 2023, to June 30, 2024. Sixty ophthalmology trainees participated in an introductory video for self-study and then completed a multiple-choice questionnaire to assess their baseline knowledge of laser indirect ophthalmoscopy for retinopathy of prematurity (LIO-ROP) and guide feedback by supervisors. The participants subsequently performed a simulated LIO-ROP on a schematic eye and received additional feedback based on a scoring rubric. The participants practiced on the schematic eye as much as needed to feel confident in their skills. Mean rubric scores indicative of LIO-ROP skills significantly improved from 2.94 to 3.59 out of 4 (P < 0.001), and the time required for the laser procedure decreased from 17.19 to 15.14 minutes in pre- and post-LIO-ROP practice, respectively. Rubric scores for performing the LIO-ROP on a schematic eye significantly improved across all steps of the procedure between pre- and post-LIO-ROP practice. Reported confidence in performing the LIO-ROP increased by 81.5%. Multifaceted simulated training informed by deliberate practice is a suitable instructional model for enhancing skill performance and confidence among postgraduate residents.
具备执行高风险手术的技能和信心对于确保患者护理安全至关重要。刻意练习是一种教学模式，旨在通过让学员参与结构化的重复练习，并由主管提供即时反馈来提高表现。我们开发了一种基于刻意练习的多方面模拟，并检验了培训后学员技能和报告的信心会增加这一假设。2023年7月1日至2024年6月30日，在泰国的三所大学进行了一项多中心前瞻性研究。60名眼科实习生观看了自学入门视频，然后完成了一份多项选择题问卷，以评估他们对早产儿视网膜病变激光间接检眼镜检查（LIO-ROP）的基线知识，并为主管提供反馈指导。参与者随后在模拟眼上进行了LIO-ROP模拟操作，并根据评分标准获得了额外反馈。参与者根据需要在模拟眼上进行练习，直到对自己的技能有信心为止。LIO-ROP技能的平均评分标准分数从满分4分中的2.94分显著提高到3.59分（P < 0.001），激光手术所需时间在LIO-ROP术前和术后练习中分别从17.19分钟降至15.14分钟。在LIO-ROP术前和术后练习之间，在模拟眼上进行LIO-ROP操作的评分标准分数在该手术的所有步骤中均显著提高。报告的进行LIO-ROP操作的信心增加了81.5%。基于刻意练习的多方面模拟训练是提高研究生住院医师技能表现和信心的合适教学模式。
