三维可视化技术结合MDT教学模式在甲状腺疾病教学中的应用

目的 探讨三维可视化模型结合多学科协作(Multidisciplinary Team,MDT)教学模式在甲状腺疾病临床教学中的应用和效果。方法 选取南京医科大学2015级和2016级临床医学系进入内分泌代谢科临床见习的60位学生为研究对象。随机分为三维教学组(n = 30 人)和传统教学组(n = 30人)。三维教学组采用三维可视化技术为学生模拟甲状腺的解剖生理、甲状腺体格检查、穿刺等,针对典型病例的临床特点,按内分泌、超声、核医学科、甲状腺外科进行分组MDT讨论,实景观摩超声定位下甲状腺穿刺操作,床边教学,最后归纳总结。传统教学组采用教师讲授为主的理论授课、教学查房以及观摩甲状腺细针穿刺操作视频。学习结束后进行理论知识和临床操作技能考核,调查问卷了解对教学方法的评价,采用t 检验对数据进行统计学分析。结果 三维教学组学生的理论考试成绩为(38.5±3.35)分,传统教学组的(38.4±3.9)分,两组比较差异未有统计学意义(P >0.05)。三维教学组学生的临床技能考核成绩为(44.3±3.2)分,优于传统教学组的(39.6±4.4)分,两组比较差异有统计学意义(t = 4.636,P <0.001)。问卷调查结果显示,三维教学组有助于理解甲状腺解剖和操作、促进知识的全面系统化掌握和应用、提高学习效率及自学能力、培养临床思维、提高分析问题及解决问题的能力。结论 三维可视化技术结合MDT的临床实习带教效果优于传统教学,有助于提高教学质量。

Application of three-dimensional visualization technology combined with MDT in thyroid disease teaching

Objective To explore the application and effect of three-dimensional visualization model combined with MDT (Multidisciplinary Team) in clinical teaching of thyroid diseases. Methods Totally 60 students from 2015 and 2016 clinical medicine departments of Nanjing Medical University were selected and randomly divided into three-dimensional teaching group (n=30) and traditional teaching group (n=30). The three-dimensional teaching group uses three-dimensional visualization technology to simulate the anatomy, physiology, physical examination and puncture of thyroid gland for students. According to the clinical characteristics of typical cases, MDT discussion is carried out in groups according to endocrine, ultrasound, nuclear medicine and thyroid surgery, and thyroid puncture operation was observed under the ultrasound positioning in groups. Bedside teaching was carried out, and finally summarized. In the traditional teaching group, teachers were mainly used to give a lecture, conduct teaching rounds and watch the operation video of thyroid fine needle puncture. At the end of the study, the theoretical knowledge and clinical operation skills were evaluated. The questionnaire was used to the evaluation of teaching methods. T-test was used to analyze the data. Results The scores of the three-dimensional teaching group were (38.5 ± 3.35) and the traditional teaching group were (38.4 ± 3.9). There was no significant difference between the two groups (P > 0.05). The scores of clinical skills of the three-dimensional teaching group were (44.3 ± 3.2), which was better than that of the traditional teaching group (39.6 ± 4.4(t = 4.636, P < 0.001). The results of questionnaire survey showed that the three-dimensional teaching group was beneficial to understand thyroid anatomy and operation, promote the mastery and application of knowledge, improve learning efficiency and self-study ability, cultivate clinical thinking, improve the ability to analyze and solve problems. Conclusion 3D visualization with combination of MDT teaching model, which seemed to be better than traditional teaching model, is helpful to improve the teaching quality.