胸腔穿刺虚拟训练系统用于临床教学的实践与思考

摘要

目的：探讨胸腔穿刺虚拟训练系统在临床教学中的应用价值。方法回顾性分析2013年4月-2014年3月在上海交通大学六院临床医学院实习的57位学生的胸腔穿刺培训资料，根据培训方式不同分为两组。联合训练组采用先虚拟胸腔穿刺教学后模具教学的方式；模具训练组采用单纯模具教学的方式。培训结束后进行学生自我评价和胸腔穿刺操作考试。结果两组学生基本资料，包括性别、实习前内科、外科、妇产科、儿科理论课程成绩没有统计学差异（P＞0．05）。自我评价方面，联合训练组在“操作流畅”和“自信程度”两方面优于模具训练组（9．27±0．87 vs 8．30±0．87，P＜0．001；8．90±0．84 vs 8．30±0．99，P＝0．016）。考试成绩方面，联合训练组在“局部麻醉”和“熟悉操作步骤”两方面优于模具训练组（8．90±0．99 vs 8．15±1．35，P＝0．019；7．40±1．16 vs 6．26±1．32，P＝0．001）。但两组在总分上没有显示统计学差异（86．80±6．06 vs 84．93±3．65，P＝0．169）。结论采用虚拟现实和模具两种方法的联合教学方式在教学效果上优于单纯模具教学，胸腔穿刺虚拟训练系统有助于提高学生胸腔穿刺操作技能。%Objective To investigate the value of virtual reality thoracentesis applied in clinical teaching .Methods We made a retrospective analysis of the thoracentesis training data of 57 students at No.6 Clinical Medical School Affiliated to Shanghai Jiaotong University between April 2013 and March 2014 .We divided the students into two groups . Combination training group received the teaching approach of mold thoracentesis after finishing virtual thoracentesis , while model training group received a single model teaching approach .Students'self-assessment and thoracentesis operation examination were arranged after training .Results There was no significant difference in sex , scores in internal medicine , surgery, gynecology and obstetrics or pediatrics before and after model training between the two groups (P>0.05).As for self-assessment, the combination training group outperformed the model training group in smooth operation and self-confidence (9.27 ±0.87 vs.8.30 ±0.87,P<0.001;8.90 ±0.84 vs.8.30 ±0.99, P=0.016).As far as examination results are concerned , the combination training group was superior to the model training group in local anesthesia and familiarity with operation procedures (8.90 ±0.99 vs. 8.15 ±1.35, P=0.019;7.40 ±1.16 vs.6.26 ±1.32, P=0.001).However, there was no significant difference in overall performance between the two groups (86.80 ±6.06 vs.84.93 ±3.65, P=0.169). Conclusion The combination training group is superior to the model training group in teaching effects . Virtual reality training system helps to improve students'operation skills of thoracentesis .