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1.上海交通大学医学院附属瑞金医院胸外科,上海 200025
2.上海交通大学医学院附属瑞金医院教育处,上海 200025
3.上海交通大学医学院附属瑞金医院教育处毕业后教育办公室,上海 200025
李鹤成,Email:lihecheng2000@hotmail.com
纸质出版日期:2024-10-20,
收稿日期:2024-03-18,
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韩丁培, 王心怡, 徐艳丽, 等. 导航支气管镜技术与人工智能辅助在支气管镜基础技能培训中的实践与思考[J]. 中华医学教育探索杂志, 2024, 23(10): 1326-1330.
Han Dingpei, Wang Xinyi, Xu Yanli, et al. Practice of navigation bronchoscopy and artificial intelligence in the basic navigational bronchoscopy skills and technique training. [J]. Chinese Journal of Medical Education Research, 2024,23(10):1326-1330.
韩丁培, 王心怡, 徐艳丽, 等. 导航支气管镜技术与人工智能辅助在支气管镜基础技能培训中的实践与思考[J]. 中华医学教育探索杂志, 2024, 23(10): 1326-1330. DOI: 10.3760/cma.j.cn116021-20240318-01831.
Han Dingpei, Wang Xinyi, Xu Yanli, et al. Practice of navigation bronchoscopy and artificial intelligence in the basic navigational bronchoscopy skills and technique training. [J]. Chinese Journal of Medical Education Research, 2024,23(10):1326-1330. DOI: 10.3760/cma.j.cn116021-20240318-01831.
目的
2
探讨导航支气管镜技术与人工智能在住院医师支气管镜基础技能规范化培训中的实践效果,以进一步提升住院医师的操作技能水平。
方法
2
选取2023年9月至2024年1月在上海交通大学医学院附属瑞金医院参加basic NBSTAT培训的26名学员为研究对象,其中包括住院医师规范化培训住院医师14名和专科医师规范化培训住院医师12名。培训采用以导航模式为核心设计理念的模块化课程,包括确定病灶、精确定位、路径规划、导航操作和实时纠错5个模块,并结合理论授课和实践操作。教学评价采用瑞金医院气管内镜模拟训练系统和电磁导航支气管镜系统进行模拟操作考核,评价学员的操作熟练度。使用SPSS 26.0软件行统计分析,运用
t
检验和Wilcoxon秩和检验进行差异显著性分析。
结果
2
培训后,所有学员的操作技能均显著提升,模拟操作时间从(125.08±48.16) s缩至(77.69±24.75) s,失误次数从1次降至0次,总评分从(60.77±15.01)分提高至(75.19±17.63)分,导航操作时间从3(3,4) min降至2(2,3) min,差异均有统计学意义;住培医师及专培医师成绩差异无统计学意义。学员对培训的总体满意率达100.00%。
结论
2
该培训课程在支气管镜基础技能培训中的实践效果显著,能够有效提升各类住院医师的支气管镜操作技能,是应对肺部疾病诊疗技术不断进步的有效途径。
Objective
2
To investigate the effects of navigation bronchoscopy and artificial intelligence in the standardized training of residents on basic bronchoscopy skills
with the goal of enhancing their practical abilities.
Methods
2
We selected 26 trainees (14 on standardized training of residents and 12 on standardized training of specialists) who participated in the basic navigational bronchoscopy skills and technique training (NBSTAT) at Ruijin Hospital
Shanghai Jiao Tong University School of Medicine from September 2023 to January 2024. The training was structured around a modular curriculum with navigation as the core design concept
consisting of five modules: lesion identification
precise localization
route planning
navigation operation
and real-time error correction. Theoretical teaching and skill practice were combined. The skill proficiency of the trainees was assessed using the Ruijin Hospital bronchoscopy simulation training system and the electromagnetic navigation bronchoscopy system. SPSS 26.0 was used to perform the
t
-test and Wilcoxon rank-sum test for comparisons.
Results
2
After the training
the trainees as a whole showed significant improvements in practicing the skills
with the simulated operation time was reduced from (125.08±48.16) seconds to (77.69±24.75) seconds
the number of errors decreased from 1 to 0
the total score increased from (60.77±15.01) to (75.19±17.63)
and the navigation operation time was reduced from 3 (3
4) minutes to 2 (2
3) minutes (all
P
<
0.05). There were no significant differences in these assessment items between resident trainees and specialist trainees. The satisfaction rate of the trainees with the training reached 100.00%.
Conclusions
2
The curriculum is effective in basic bronchoscopy skill training
remarkably enhancing the bronchoscopy skills of resident and specialist physicians
which is a useful approach for physicians to cope with the continuous development of diagnostic and therapeutic techniques for pulmonary diseases.
导航支气管镜住院医师规范化培训导航理念模块化训练临床技能提升
Navigational bronchoscopyStandardized training of residentsNavigational conceptModular trainingClinical skill enhancement
Bowling MR, Folch EE, Khandhar SJ, et al. Fiducial marker placement with electromagnetic navigation bronchoscopy: a subgroup analysis of the prospective, multicenter NAVIGATE study [J]. Ther Adv Respir Dis, 2019, 13: 1753466619841234. DOI: 10.1177/1753466619841234http://dx.doi.org/10.1177/1753466619841234.
Kuo SW, Tseng YF, Dai KY, et al. Electromagnetic navigation bronchoscopy localization versus percutaneous CT-guided localization for lung resection via video-assisted thoracoscopic surgery: a propensity-matched study [J]. J Clin Med, 2019, 8(3): 379. DOI: 10.3390/jcm8030379http://dx.doi.org/10.3390/jcm8030379.
杨超, 彭桂林, 徐鑫, 等. 胸外科临床医学专业学位研究生内镜培训体系改革探讨[J]. 基础医学教育, 2021, 23(6): 418-420. DOI: 10.13754/j.issn2095-1450.2021.06.15http://dx.doi.org/10.13754/j.issn2095-1450.2021.06.15.
杨溯, 郭威, 吴晗, 等. 胸外科医生机器人手术培训模式: 瑞金医院单中心研究[J]. 中国胸心血管外科临床杂志, 2020, 27(8): 918-921. DOI: 10.7507/1007-4848.202003081http://dx.doi.org/10.7507/1007-4848.202003081.
郭威, 杨溯, 李鹤成. 以创新科研能力为导向的胸外科研究生培养模式: 瑞金医院单中心研究[J]. 中国胸心血管外科临床杂志, 2020, 27(4): 454-456. DOI: 10.7507/1007-4848.202001065http://dx.doi.org/10.7507/1007-4848.202001065.
陈香, 张亚杰, 韩丁培, 等. 电磁导航支气管镜引导下肺结节术前定位183例的单中心临床分析[J]. 中国胸心血管外科临床杂志, 2023, 30(11): 1539-1544.
许玲, 胡蓬勃. 纤维支气管镜的情景模拟法教学在住院医师规范化培训中的研究[C]//南京康复医学会. 第三届全国康复与临床药学学术交流会议论文集, 2022: 5.
凌琳, 付娟娟, 范懿隽, 等. 虚拟现实技术在住院医师规范化培训中的应用[J]. 医学教育管理, 2023, 9(3): 360-364. DOI: 10.3969/j.issn.2096-045X.2023.03.016http://dx.doi.org/10.3969/j.issn.2096-045X.2023.03.016.
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