视频教学法在超声引导下中心静脉穿刺的应用评价
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摘要
目的对比观察视频教学与基础知识教学在超声引导中心静脉穿刺的应用效果评价。方法选择2017年10月—2018年5月于我院麻醉科临床实习医师52人作为研究对象。将其随机分为视频教学(videoteaching,VT)组及基础知识教学(lecture-based teaching,LBT)组。LBT组完成45min课程幻灯片演示,并学习相关文档;VT组给予相同的基础知识教学,并给予可反复观看的教学视频。培训完成后在超声实施模型上进行平面内法和平面外穿刺行中心静脉穿刺,应用7个关键步骤相对应的0～7评分法评估其总体得分、穿透发生率及实时超声引导应用率。结果 VT组总体得分高于LBT组,VT组的穿透发生率低于LBT组,同时实时超声引导的应用率增加,组间各数据比较,差异均具有统计学意义(P <0.05)。结论视频教学在超声引导下中心静脉穿刺技能操作培训上优于基础知识教学。
Objective To observe the effect of video and lecture based learning method of central venous catheter placement guided by ultrasound in Physicians Training. Methods 52 clinical interns in anesthesiology department of our hospital from October 2017 to May 2018 were selected as the research subjects. They were randomly divided into video teaching(VT) group and lecture-based teaching(LBT) group. LBT group completed45 minutes course slide demonstration and learned relevant documents. The VT group was given the same basic knowledge teaching and the teaching video which could be watched repeatedly. After the training, in-plane and out-of-plane punctures were performed on the ultrasound implementation model. The overall score, penetration rate and real-time application rate of ultrasound guidance were evaluated by 0 ～ 7 score method corresponding to seven key steps. Results The overall score and ultrasound guided application rate in the video learning group were significantly better than those in the lecture based learning group, and the incidence of pierce through events decreased significantly(P < 0.05). Conclusion Video teaching is superior to basic knowledge teaching in the training of central venipuncture skills under the guidance of ultrasound.
Objective To observe the effect of video and lecture based learning method of central venous catheter placement guided by ultrasound in Physicians Training. Methods 52 clinical interns in anesthesiology department of our hospital from October 2017 to May 2018 were selected as the research subjects. They were randomly divided into video teaching(VT) group and lecture-based teaching(LBT) group. LBT group completed45 minutes course slide demonstration and learned relevant documents. The VT group was given the same basic knowledge teaching and the teaching video which could be watched repeatedly. After the training, in-plane and out-of-plane punctures were performed on the ultrasound implementation model. The overall score, penetration rate and real-time application rate of ultrasound guidance were evaluated by 0 ～ 7 score method corresponding to seven key steps. Results The overall score and ultrasound guided application rate in the video learning group were significantly better than those in the lecture based learning group, and the incidence of pierce through events decreased significantly(P < 0.05). Conclusion Video teaching is superior to basic knowledge teaching in the training of central venipuncture skills under the guidance of ultrasound.
引文
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[9]Chan A,Singh S,Dubrowski A,et al. Part versus whole:a randomized trial of central venous catheterization education[J]. Adv Health Sci Educ Theory Pract,2015,20(4):1061-1071.
[10]吴文,聂昆,夏婧,等.不同超声引导平面技术在颈内静脉穿刺置管术中的临床应用[J].临床麻醉学杂志,2016,32(5):449-452.
[11]Dietrich CF,Horn R,Morf S,et al. Ultrasound-guided central vascular interventions, comments on the European Federation of Societies for Ultrasound in Medicine and Biology guidelines on interventional ultrasound[J]. J Thorac Dis,2016,8(9):E851-E868.
[12]Veen M,de la Croix A. The swamplands of reflection:using conversation analysis to reveal the architecture of group reflection sessions[J]. Med Educ,2017,51(3):324-336.
[2]Sobolev M,Shiloh AL,Di Biase L,et al. Ultrasound-guided cannulation of the femoral vein in electrophysiological procedures:a systematic review and meta-analysis[J]. Europace,2017,19(5):850-855.
[3]齐小冰,郭卫东.超声引导下行小儿颈内静脉穿刺置管术50例[J].中国冶金工业医学杂志,2015,32(2):230-231.
[4]杨柳,李萍,王花.超声引导在危重症患者中心静脉穿刺置管中的应用[J].生物医学工程与临床,2017,21(5):499-501.
[5]庞晓磊.超声引导下中心静脉穿刺置管的应用效果观察[J].河南医学研究,2018,27(12):2255-2256.
[6]郭晨明,付明刚,郭丽英.视频教学在外科学临床教学中的应用[J].继续医学教育,2014,28(5):49-50.
[7]Nesbitt C,Phillips AW,Searle R,et al. Student Views on the Use of 2 Styles of Video-Enhanced Feedback Compared to Standard Lecture Feedback During Clinical Skills Training[J]. J Surg Educ,2015,72(5):969-973.
[8]崔利丹,金志鹏,王琪,等.床旁超声引导下中心静脉置管在危重患儿治疗中的应用[J].新乡医学院学报,2017,34(3):241-244.
[9]Chan A,Singh S,Dubrowski A,et al. Part versus whole:a randomized trial of central venous catheterization education[J]. Adv Health Sci Educ Theory Pract,2015,20(4):1061-1071.
[10]吴文,聂昆,夏婧,等.不同超声引导平面技术在颈内静脉穿刺置管术中的临床应用[J].临床麻醉学杂志,2016,32(5):449-452.
[11]Dietrich CF,Horn R,Morf S,et al. Ultrasound-guided central vascular interventions, comments on the European Federation of Societies for Ultrasound in Medicine and Biology guidelines on interventional ultrasound[J]. J Thorac Dis,2016,8(9):E851-E868.
[12]Veen M,de la Croix A. The swamplands of reflection:using conversation analysis to reveal the architecture of group reflection sessions[J]. Med Educ,2017,51(3):324-336.