前列腺电切模拟机表面效度和内容效度研究

摘要

目的 评估前列腺电切模拟机的表面效度和内容效度.方法 2010年9月至2011年6月参加经尿道前列腺电切模拟培训的泌尿外科医师根据既往前列腺电切手术例数分为有经验组(手术例数＞50例)30人和无经验组(手术例数≤50例)30人,通过前列腺电切模拟机模拟电切25～80 g前列腺后,进行问卷调查,涉及前列腺电切模拟机用作住院医师培训、真实性和全面评分等11条项目.比较两组医师对模拟机评分的差异及用作住院医师培训与真实性和全面评分的相关性.TURP模拟培训2d,用Easy 2模块评价培训效果.结果 前列腺电切模拟机用作泌尿外科住院医师培训在有、无经验组分别为(8.8±1.1)分和(8.5±1.4)分,真实性分别为(8.0±1.2)分和(8.4±1.1)分,全面评分分别为(8.7±0.9)分和(8.6±0.8)分,两组比较差异均无统计学意义(P＞0.05).有经验组用作住院医师培训与真实性和全面评分呈正相关(r =0.625、0.691,P＜0.05).无经验组模拟培训后TURP前列腺腺体切除率(87.3％±7.7％)、出血控制率(94.4％±6.6％)和安全性(95.2％±5.5％)均有明显提高(t=-3.689、-2.274、-2.507,P＜0.05).结论 前列腺电切模拟机的表面效度和内容效度好,且TURP模拟培训能提高无经验组医师电切技能.因此,前列腺电切模拟机可用作泌尿外科住院医师培训.%Objective To evaluate the face and content validation of the virtual reality transurethral resection of the prostate simulator(TURPSimTM).Methods The 60 urology doctor aged 26-50 years old all over the country were enrolled for virtual reality training of TURP from September 2010 to June 2011.Participants classified as experts(more than 50 procedures performed)and novices(50 or fewer procedures performed)performed TURPs on TURPSimTM involving resection of 25-80 g prostate.They completed questionnaires regarding utility for residency training,realism and overall score of the TURPSimTM.Performances of two groups were evaluated after 2-day training.Results were recorded and analyzed.Results Mean utility for residency training,realism and overall score were(8.8 ± 1.1)and(8.5 ± 1.4),(8.0 ± 1.2)and(8.4 ± 1.1),(8.7 ± 0.9)and(8.6 ± 0.8)in experts and novices respectively.There was no significant difference between two groups(P ＞ 0.05).Spearman's correlation coefficients analysis showed an significant positive correlation between utility for residency training and realism(r =0.625,P =0.000),utility for residency training and overall score(r =0.691,P =0.000)in experts,utility for residency training and realism(r =0.702,P =0.000),utility for residency training and overall score(r =0.664,P =0.001)in novices.Prostate resection rate(87.3 ％ ± 7.7 ％),bleeding control rate(94.4％ ± 6.6％)and safety(95.2％ ±5.5％)in novices increased after training(t =-3.689,-2.274,-2.507,all P ＜ 0.05).Conclusions The face and content validation of transurethral resection of the prostate simulator is good,virtual reality training of TURP may improve the skills necessary to perform TURP.Transurethral resection of the prostate simulator can be used to train urology residents.