1.中山大学附属第一医院麻醉科,广州 510080
2.中山大学附属第一医院肝胆胰外科中心,广州 510080
Zhou Qin, Email: zhouqin5@mail.sysu.edu.cn
Received:14 April 2026,
Online First:01 July 2026,
移动端阅览
Ye Jianhong, Guo Junying, He Qiulan, et al. Screen-based simulation for crisis management training in anesthesiology residents: evaluation of non-technical skills development[J/OL]. Chinese Journal of Medical Education Research, 2026, 1-9.
Ye Jianhong, Guo Junying, He Qiulan, et al. Screen-based simulation for crisis management training in anesthesiology residents: evaluation of non-technical skills development[J/OL]. Chinese Journal of Medical Education Research, 2026, 1-9. DOI: 10.3760/cma.j.cn116021-20260414-02318.
目的
2
比较基于结构化反馈的屏幕模拟(screen-based simulation,SBS)与高仿真模拟(high-fidelity simulation,HFS)对麻醉住院医师非技术性技能(anaesthetists’ non-technical skills,ANTS)培训的效果。
方法
2
将2022年6月至2024年6月在中山大学附属第一医院麻醉专业基地的48名住院医师随机分为SBS组与HFS组(各24名)。两组均接受每周1次、连续3周的危机案例培训及导师结构化反馈。于培训后第4周及3个月后行原位模拟考核;由3名盲法评价员评定ANTS总分、4个维度(态势感知、团队合作、任务管理、决策制定)得分、关键行为完成率及团队协作次数,并进行满意度调查。借助SPSS 26.0分析数据,采用单侧95%置信区间法进行非劣效性检验。
结果
2
培训后第4周,两组ANTS总分及4个维度得分均较基线显著提升(
P
<
0.001),其中SBS组总分为11.81±2.18,HFS组总分为12.02±1.54,组间差异无统计学意义(
t
=-0.39,
P
=0.702,Cohen’s
d
=-0.11),4个维度得分差异亦无统计学意义(均
P
>
0.05)。3个月后评估,两组ANTS总分维持稳定,SBS组(11.70±1.90)与HFS组(11.90±1.80)差异仍无统计学意义(
t
=-0.42,
P
=0.710,
d
=-0.11)。两组关键行为完成率的组间差异无统计学意义(
P
>
0.05),但HFS组团队协作次数显著高于SBS组(
P
<
0.001);两组均认同培训有效,尽管62.50%的学员更偏好HFS体验,但该偏好未转化为客观技能优势。
结论
2
基于结构化反馈的屏幕模拟能有效提升并维持麻醉住院医师危机处理的非技术性技能,效果不劣于HFS,且具备低成本、易推广的优势,可作为常态化临床模拟培训的补充。
Objective
2
To evaluate the effect of screen-based simulation (SBS) with structured feedback versus high-fidelity simulation (HFS) in anesthetists' non-technical skills (ANTS) training.
Methods
2
A total of 48 residents at the anesthesiology training base of The First Affiliated Hospital
Sun Yat-sen University were randomly assigned to the SBS group or HFS group (
n
=24 each) from June 2022 to June 2024. Both groups received weekly crisis scenario training and str
uctured feedback from instructors for 3 consecutive weeks. At the 4th week and 3 months post-training
trainees were assessed via
in situ
simulations using new cases. Three blinded raters evaluated the total ANTS score and the scores of four dimensions (situation awareness
team working
task management
and decision making)
key behavior completion rate
and team collaboration frequency. Trainee satisfaction was surveyed. SPSS 26.0 was used for data analysis
and non-inferiority was assessed using a one-sided 95% confidence interval.
Results
2
At the 4th week post-training
the total ANTS score and scores of the four dimensions improved significantly from baseline in both groups (
P
<
0.001)
with no significant difference between the SBS group and the HFS group for the total score (11.81±2.18 vs. 12.02±1.54
t
=-0.39
P
=0.702
Cohen's
d
=-0.11) or any of the four dimensions (
P
>
0.05). At 3 months post-training
the total ANTS score remained stable with no significant difference between the SBS group and the HFS group (11.70±1.90 vs. 11.90±1.80
t
=-0.42
P
=0.710
d
=-0.11). The key behavior completion rate was not significantly different between the two groups (
P
>
0.05)
but the HFS group had significantly more team collaborations than the SBS group (
P
<
0.001). All trainees found the training effective; although 62.50% preferred HFS
this did not translate into objective skill advantages. Conclusionss SBS with structured feedback can effectively enhance and maintain ANTS during crisis management
and is non-inferior to HFS. With its cost-effectiveness and scalability
SBS with structured feedback can serve as a supplementary approach for routine clinical simulation training.
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