“组块化分步学习”的培训模式在经直肠超声引导下前列腺穿刺活检培训中的应用

目的：探讨经直肠超声引导下前列腺穿刺活检术的教学方法，缩短学习曲线，减少学习期手术相关问题的发生。方法：将完全未接触经直肠超声操作及穿刺相关操作的具有2-3年泌尿外科工作经验的住院医生6名随机分为两组。两组均进行经直肠超声引导下的12针前列腺穿刺活检术。实验组采用“组块化分步学习”的培训模式进行；对照组采用传统的讲解 操作示教 全过程独立操作的学习方法进行。14天后对两组学员进行操作考试并进行针对该培训的问卷调查。统计并比较两组学生操作技能和规范的掌握程度及问卷调查结果。结果：实验组学员14天后全部3名学员都能顺利进行该操作，而对照组只有1名学员能顺利规范完成。问卷调查显示，实验组3名学员均感觉该培训过程有趣而且不难，在实际操作过程也没有出现紧张的情况；而对照组3名学员中只有1人感到操作过程较容易，另外两人感觉学习过程枯燥乏味，操作掌握难度较大，在实际患者身上操作过程中容易紧张、遗忘。结论：“组块化分步学习”的培训过程，能够极大地提高学员的学习效率，增强学员的学习兴趣，循序渐进的培训过程使该操作的学习过程变得简单有趣。

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Objective To explore the teaching method for transrectal ultrasound guided prostate biopsy, so as to shorten the learning curve and reduce the complications during the study period. Methods Six residents of urology, who had 2-3 years experience of urology and had no experience in transrectal ultrasound biopsy, were randomly divided into two groups: experimental group and control group (n=3). All the members were trained to perform transrectal ultrasound-guided 12 needle biopsy of the prostate. The experimental group received the modularized step-by-step training mode; and the control group received the traditional method, which included operation teaching and independent operation of the whole process. Fourteen days later,all the members were tested for manipulation and surveyed by questionnaires on the training. Results All the 3 residents in the experimental group were capable to perform the operation successfully after 14 days, while only 1 resident in the control group can do it smoothly. The questionnaire survey showed that, all the 3 residents in the experimental group thought that the training procedure was easy and interesting, and they were not nervous during the operation. In the control group, only 1 resident felt it was easy, and the other 2 felt it was difficult and boring, and they were liable to be nervous and forgetful in clinical practice. Conclusion The modularized step-by-step training mode can greatly improve the learning efficiency of training for transrectal ultrasound guided prostate biopsy, making the learning process simple and interesting.