不同模拟穿刺模型在超声引导穿刺技术教学中的比较研究
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摘要
目的对比三种模拟穿刺模型(商业化的蓝胶模型、自制明胶模型及自制豆腐模型)在超声引导穿刺技术教学中的应用,比较其可行性、教学效果,为教学工作中选择合适的教具提出参考。方法招募南京医科大学二年级以上的在校学生30名,均经过超声引导下神经阻滞技术学习后,尝试在模型上实施超声引导下神经阻滞,以报数的顺序分配模拟穿刺模型,每名学生每种模型模拟练习15 min,最终完成三种模型的模拟训练。穿刺训练完成后,指导教师评估培训效果,学生需从仿真程度、耐用性、易清洁性、图像识别度及偏好程度五个方面,采用数字评分评价三种模型。结果指导教师依据学生操作过程中针道显影的清晰程度,对培训效果进行评价,三组学生间的评分比较差异无统计学意义。模型的仿真程度、耐用性、易清洁性的评分方面比较,蓝胶模型优于明胶模型和豆腐模型,差异均有统计学意义(均P<0.05)。三种模型图像识别度评分比较差异无统计学意义。获知模型价格前,各有40%学员偏好蓝胶模型和明胶模型,仅20%学员偏好豆腐模型;获知模型价格后,73%学员偏好明胶模型。结论超声引导下模拟穿刺技术教学的教学模型选择需结合教学需求、费用预算及学员的偏好等多方面进行综合评估。在需要自主设计的穿刺模型中,明胶模型有较大的优势。
Objective To compare three simulated puncture models(a commercially available model manufactured by Blue Phantom,a homemade gelatin model and a homemade tofu model) in the teaching of ultrasound-guided puncture technology,and to compare their feasibility and teaching effect,so as to provide reference for the selection of appropriate teaching model.Methods Thirty students from the second year of Nanjing Medical University were enrolled in the study.All participants were recruited following an ultrasound guided regional nerve block tutorial.Following the tutorial,ultrasound guided nerve blocks was performed by three different simulated models.Participants were assigned to each station in counting order and each student simulated each model for 15 min,ultimately completed all three stations.After the puncture training is completed,the instructor evaluated the training effects,and the study participants need to evaluate the three models using numerical scores in terms of simulation level,durability,easy cleaning,image recognition degree and preference. Results The instructor evaluated the training effect according to the clarity of needle-track development in the process of students' operation,and there was no statistically significant difference among the three groups.The Blue Phantom model was superior to the gelatin model and the tofu model in regard to simulation level,durability and cleanliness,the difference were statistically significant(both P<0.05).There was no significant difference in image recognition scores among the three groups.Prior to revealing the price of the models,40% of the participants preferred the Blue Phantom model and the homemade gelatin model,only 20% of the students preferred the homemade tofu model.After revealing the price of each model,73% preferred the gelatin model.Conclusion The selection of ultrasound-guided simulated puncture teaching needs to be evaluated according to the teaching needs,cost budget and students' preferences.In the puncture models that need to be designed independently,the gelatin model has great advantages.
Objective To compare three simulated puncture models(a commercially available model manufactured by Blue Phantom,a homemade gelatin model and a homemade tofu model) in the teaching of ultrasound-guided puncture technology,and to compare their feasibility and teaching effect,so as to provide reference for the selection of appropriate teaching model.Methods Thirty students from the second year of Nanjing Medical University were enrolled in the study.All participants were recruited following an ultrasound guided regional nerve block tutorial.Following the tutorial,ultrasound guided nerve blocks was performed by three different simulated models.Participants were assigned to each station in counting order and each student simulated each model for 15 min,ultimately completed all three stations.After the puncture training is completed,the instructor evaluated the training effects,and the study participants need to evaluate the three models using numerical scores in terms of simulation level,durability,easy cleaning,image recognition degree and preference. Results The instructor evaluated the training effect according to the clarity of needle-track development in the process of students' operation,and there was no statistically significant difference among the three groups.The Blue Phantom model was superior to the gelatin model and the tofu model in regard to simulation level,durability and cleanliness,the difference were statistically significant(both P<0.05).There was no significant difference in image recognition scores among the three groups.Prior to revealing the price of the models,40% of the participants preferred the Blue Phantom model and the homemade gelatin model,only 20% of the students preferred the homemade tofu model.After revealing the price of each model,73% preferred the gelatin model.Conclusion The selection of ultrasound-guided simulated puncture teaching needs to be evaluated according to the teaching needs,cost budget and students' preferences.In the puncture models that need to be designed independently,the gelatin model has great advantages.
引文
[1] Shank ES,Martyn JA,Donelan MB,et al.Ultrasound-guided regional anesthesia for pediatric burn reconstructive surgery:A prospective study[J].J Burn Care Res,2016,37(3):213-217.
[2]贺雪梅,涂波,李玲,等.应用仿真体模进行超声介入技术临床培训的方法探索[J].中华医学教育探索,2014,13(12):1219-1221.
[3] Sultan SF,Shorten G,Iohom G.Simulators for training inultrasound guided procedures[J].Med Ultrason,2013,15(2):125-131.
[2]贺雪梅,涂波,李玲,等.应用仿真体模进行超声介入技术临床培训的方法探索[J].中华医学教育探索,2014,13(12):1219-1221.
[3] Sultan SF,Shorten G,Iohom G.Simulators for training inultrasound guided procedures[J].Med Ultrason,2013,15(2):125-131.