沙盘模拟在产科专科培训的应用初探

目的探讨沙盘模拟培训在产科专科培训应用中的可行性和有效性。 方法培训班以沙盘模拟形式对学员进行产科急危重症与助产技术培训,采用"沙盘推演—学员操作—导师点评—导师演示"的培训模式,内容包括子痫、产后出血、肩难产、阴道助产和新生儿窒息复苏。选取200名学员为研究对象,并随机分成5个团队,培训前后对学员进行理论知识和操作技能考核,根据考核标准由导师组进行打分,并对每个团队的抢救流程进行考核评分。同时培训前后发放调查问卷对培训课程进行反馈。 结果经培训后,学员的理论考核成绩(91.1±14.5)分较培训前(75.6±24.0)分明显提高,差异有统计学意义(P<0.05)。各操作模块考核前后成绩分别为：子痫(73.7±5.6)分与(90.6±3.9)分,产后出血(71.2±8.7)分与(88.9±4.8)分,阴道助产(70.1±7.9)分与(90.0±4.8)分,肩难产(74.6±5.7)分与(91.5±2.3)分,新生儿窒息(73.2±4.7)分与(91.2±2.5)分,培训后成绩明显提高,差异有统计学意义(P<0.05)。团队考核的Topsis分析结果显示,团队3在多项指标上都是最优秀的,综合排名第一名,尤其是方案设计。团队5在临床技能表现突出,在团队配合和患者沟通方面做得也比较好。团队2和团队4各项指标都表现不足。 结论团队3大部分成员来自三甲医院,经常参加产科模拟培训班,因此总体素质较高,而团队2和团队4来自基层医院的成员居多,接受培训的次数较少,因此成绩偏弱,尤其在流程、沟通和团队配合等方面,还需要加强培训。沙盘模拟培训作为一种新型的体验式培训模式,具有创新性、互动性、趣味性,并具有实战性,在产科急危重症专科培训中具有较大的发展前景。

Application of sand table simulation in obstetrics specialist training

Objective To explore the feasibility and effectiveness of sand table simulation training in obstetrics training.Methods The training class conducted training on critical obstetric disease and midwifery techniques in the form of sand table simulation,and adopted the training mode of“sand table rehearsal--trainees′operation--tutor′s comment--tutor′s demonstration”,including eclampsia,postpartum hemorrhage,shoulder dystocia,vaginal midwifery and neonatal asphyxia resuscitation.200 trainees were randomly divided into 5 teams as the research objects.Trainees were assessed on theoretical knowledge and operational skills before and after the training,and were graded by the tutor group according to the assessment criteria,and the rescue process of each team was assessed and scored.Results After training,the score of theoretical assessment(91.1±14.5)was significantly higher than that before(75.6±24.0),the difference has statistically significant(P<0.05).After training,the scores of each operation module includes before and after training scores:eclampsia(73.7±5.6)and(90.6±3.9),postpartum hemorrhage(71.2±8.7)and(88.9±4.8),vaginal Midwifery(70.1±7.9)and(90.0±4.8),shoulder dystocia(74.6±5.7)and(91.5±2.3),neonatal asphyxia(73.2±4.7)and(91.2±2.5).The scores were significantly improved with statistic difference(P<0.05).The results of TOPSIS analysis show that team 3 is the best in many indicators,ranking first in comprehensive ranking,especially in scheme design.Team 5 has outstanding clinical skills,and done well in team cooperation and patient communication.All indicators of team 2 and team 4 are underperforming.Conclusions Most of the members of team 3 come from three-A hospitals and often participate in obstetric simulation training courses and their overall quality is high.While most of the members of team 2 and team 4 come from the basic hospitals and receive less training,their performance is weak especially in the aspects of process,communication and team cooperation,etc.It shows that they need further strengthen training.As a new type of experiential training mode,sand table simulation training is innovative,interactive,interesting and pratical significance,it has great development prospects in the emergency training of obstetrics and critical illness.