基于虚拟超声模型评价超声住院医师操作技能培训效果

目的探讨应用虚拟超声模型评价超声住院医师操作技能培训效果的价值。 方法选取在北京协和医院超声医学科参加住院医师规范化培训的2019级住院医师11人，应用虚拟超声模型考核腹部器官的7个正常超声切面和3个病例切面的显示，完成病灶最大切面的长径与短径共6个测量值的测量，并与高年资医师的测量值进行比较。经过2个月门诊实践练习后，再次应用虚拟超声模型进行考核。练习前后分别记为G0M组和G2M组（G，Group；M，Month）。应用Mann-Whitney U检验比较2组检查用时的差异，应用单样本t检验比较住院医师测量值与高年资医师测量值的差异，应用χ²检验（Fisher精确概率法）比较切面合格率和完成率的组间差异。 结果G0M组获取7个正常超声切面的合格率为59.46%（44/74），检查用时为（8.18±2.96）min。G2M组71.43%的切面合格率均提高，合格率达到88.31%（68/77），检查用时下降为（5.45±1.57）min，与G0M组相比差异均具有统计学意义（χ²=44.101，P＜0.001；t=-2.698，P=0.014）。G2M组对3个病例切面的完成率较G0M组提高，但组间差异无统计学意义（P均＞0.05）。G2M组对病例1和病例2的检查用时较G0M组减少［1.00（2.00，1.00）min vs 3.00（4.00，2.00）min；2.00（2.00，1.00）min vs 2.50（3.00，2.00）min］，2组间差异具有统计学意义（Z=-3.089、-2.061，P=0.002、0.039）。G2M组对病例3长径的测量准确性较G0M组下降，与高年资医师比较［（8.42±0.88）cm vs 9.45 cm］，差异具有统计学意义（t=-3.097，P=0.021）。 结论虚拟超声模型可用于评价超声住院医师初学阶段和练习期间的操作技能培训效果。

Evaluation of effects of skill training of ultrasound residents based on an ultrasound simulator

ObjectiveTo assess the value of an ultrasound simulator in evaluating the effect of ultrasonic residents training. MethodsEleven residents who underwent standardized resident training at Department of Ultrasound of Peking Union Medical College Hospital were selected. Seven normal ultrasound sections and three cases of abdominal organs were displayed by residents using an ultrasound simulator, and six parameters such as the long diameter and short diameter of the largest section of the lesion were completed, which were compared with the measurements of senior doctors. After two months of outpatient practice, the virtual ultrasound model was used again for resident evaluation, which was recorded as G0M and G2M (G, group; M, month) before and after the exercise. Mann-Whitney U test was used to compare the examination time between the two groups, and independent sample t-test was used to compare the measurements between residents and senior doctors. Chi-square test (Fisher exact probability test) was used to compare the completion rate and the qualified rate between the two groups. ResultsThe average qualified rate of seven normal sections in G0M was 59.46% (44/74), and the average examination time was (8.18±2.96) min. In G2M, the qualified rate was 71.43%, the average qualified rate was increased to 88.31%, and the average time was reduced to (5.45±1.57) min, which were significantly different from those in G0M (χ²=44.101, P＜0.001; t=-2.698, P=0.014). The completion rate for the three cases in G2M was higher than that in G0M, but there was no significant difference between the two groups (P＞0.05). The examination time for case 1 and case 2 in G2M was less than that in G0M 1.00 (2.00, 1.00) min vs 3.00 (4.00, 2.00) min; 2.00 (2.00, 1.00) min vs 2.50 (3.00, 2.00) min], and the difference between the two groups was statistically significant (Z=-3.089 and -2.061, P=0.002 and 0.039, respectively). The long diameter measurement accuracy for case 3 in the G2M group was lower than that of the G0M group, and there was a significant difference between G2M and senior doctors (8.42±0.88) cm vs 9.45 cm; t=-3.097, P=0.021]. ConclusionThe ultrasound simulator can be used to evaluate the effects of skill training of ultrasound residents during the initial and practice stage.