Application of the flipped classroom combined with learning curves in training on Shikani laryngoscope-guided endotracheal intubation

Wang Mingya; Zhang Hua; Fang Yinglun; Zhou Yang; Xu Mao; Guo Xiangyang; Han Yongzheng

doi:10.3760/cma.j.cn116021-20250219-02058

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Application of the flipped classroom combined with learning curves in training on Shikani laryngoscope-guided endotracheal intubation

Standardized Residency Training | 更新时间：2025-09-22

- Application of the flipped classroom combined with learning curves in training on Shikani laryngoscope-guided endotracheal intubation
- Chinese Journal of Medical Education Research Vol. 24, Issue 9, Pages: 1253-1258(2025)
- 作者机构：
  
  1.北京大学第三医院麻醉科，北京 100191
  2.北京大学第三医院流行病学研究中心，北京 100191
- 作者简介：
  
  Han Yongzheng, Email: hanyongzheng@bjmu.edu.cn
- 基金信息：
  
  The Teaching Research Topic of Peking University Third Hospital(2023BYSYJXKT02)
- DOI：10.3760/cma.j.cn116021-20250219-02058
  CLC： R614
- Received：19 February 2025，
  
  Published：20 September 2025
- 稿件说明：
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王明亚, 张华, 方英伦, 等. 翻转课堂联合学习曲线在Shikani喉镜引导气管插管培训中的应用[J]. 中华医学教育探索杂志, 2025, 24(9): 1253-1258.

Wang Mingya, Zhang Hua, Fang Yinglun, et al. Application of the flipped classroom combined with learning curves in training on Shikani laryngoscope-guided endotracheal intubation[J]. Chinese journal of medical education research, 2025, 24(9): 1253-1258.
王明亚, 张华, 方英伦, 等. 翻转课堂联合学习曲线在Shikani喉镜引导气管插管培训中的应用[J]. 中华医学教育探索杂志, 2025, 24(9): 1253-1258. DOI： 10.3760/cma.j.cn116021-20250219-02058.

Wang Mingya, Zhang Hua, Fang Yinglun, et al. Application of the flipped classroom combined with learning curves in training on Shikani laryngoscope-guided endotracheal intubation[J]. Chinese journal of medical education research, 2025, 24(9): 1253-1258. DOI： 10.3760/cma.j.cn116021-20250219-02058.

摘要

目的

探讨麻醉学住院医师学习Shikani喉镜引导气管插管的学习规律，为临床麻醉医师的技能培训提供参考依据。

方法

2023年8月至2024年12月在北京大学第三医院共有19名麻醉学专业住院医师参与该研究。所有住院医师均接受统一规范的临床技能培训，在Shikani喉镜气管插管操作方面均未接受过专项训练，其相关理论教学与实操指导均由同一位高年资主治医师全程负责。采用翻转课堂教学模式，并由带教教师指导每名学生按照时间顺序临床实践操作15个病例，总计285例。计算每一次气管插管操作的累积和（cumulative sum，CUSUM）值，使用R软件制作学习曲线；通过4次多项式非线性回归模型进行曲线拟合并估算该学习曲线的95%置信区间。进一步解析回归模型的一阶导数函数，揭示操作熟练度随训练次数的动态演变规律。基于极大值统计量检验法对累积得分曲线进行分割点检测，寻找CUSUM的最优分界点。

结果

采用最大选择检验发现，操作次数为8次时为CUSUM上升水平的分界点。

结论

麻醉学专业住院医师在接受8次规范化培训后即可熟练掌握Shikani喉镜引导气管插管且学员对翻转课堂教学模式满意度较高。

Abstract

Objective

To explore the learning patterns of resident physicians in anesthesiology when performing tracheal intubation guided by Shikani laryngoscope

and provide a reference for the skill training of clinical anesthesiologists.

Methods

From August 2023 to December 2024

a total of 19 resident physicians specializing in anesthesiology participated in this study at Peking University Third Hospital. All resident physicians received standardized training on clinical skills. None of them had received specialized training in Shikani laryngoscope-guided tracheal intubation. The relevant theoretical teaching and practical guidance were provided by the same senior attending physician throughout the study. A flipped-classroom teaching model was adopted

and each student was instructed by the teaching physician to perform the procedure on 15 cases in chronological order

resulting in a total of 285 cases. The cumulative sum (CUSUM) value for each tracheal intubation was calculated

and the learning curve was plotted using R software. A fourth-order polynomial nonlinear regression model was used to fit the curve and estimate the 95% confidence interval of the learning curve. The first-order derivative function of the regression model was further analyzed to reveal the dynamic changes in proficiency with the number of training sessions. The CUSUM curve was segmented using the maximum statistics test to identify the optimal breakpoint.

Results

The maximum selection test revealed that the breakpoint for the increase in CUSUM level was at the eighth attempt.

Conclusions

Resident physicians in anesthesiology can master Shikani laryngoscope-guided tracheal intubation after eight standardized training sessions. Moreover

the participants showed high satisfaction with the flipped-classroom teaching model.

关键词

Keywords

references

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