基础医学与临床 ›› 2020, Vol. 40 ›› Issue (7): 1004-1010.

• 医学教育 • 上一篇    下一篇

模拟器教学对超声气管镜针吸活检学习和肺癌患者基因检测充分性的影响

陈闽江, 徐燕, 赵静, 孙雪峰, 钟巍*, 王孟昭*   

  1. 中国医学科学院 北京协和医学院 北京协和医院 呼吸与危重症医学科,北京 100730
  • 收稿日期:2020-04-07 修回日期:2020-05-17 出版日期:2020-07-05 发布日期:2020-06-29
  • 通讯作者: *zw_pumch@126.com;mengzhaowang@sina.com
  • 基金资助:
    国家自然科学基金(81702292);国家“十三五”重大新药创制专项子课题“创新药物临床评价示范性平台建设”(2019ZX09734001-002);中国医学科学院医学与健康科技创新工程(2018-I2M-1-003)

Impact of simulation-based training in learning of endobronchial ultrasound-guided transbronchial needle aspiration and specimen acquisition for genotyping of lung cancer

CHEN Min-jiang, XU Yan, ZHAO Jing, SUN Xue-feng, ZHONG Wei*, WANG Meng-zhao*   

  1. Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China
  • Received:2020-04-07 Revised:2020-05-17 Online:2020-07-05 Published:2020-06-29
  • Contact: *zw_pumch@126.com;mengzhaowang@sina.com

摘要: 目的 比较两种不同教学方法下超声气管镜针吸活检(EBUS-TBNA)操作者的学习曲线、操作准确率及取材充分性,为更好地培训介入操作医师提供新思路。方法 收集北京协和医院内镜中心自2015年1月至2019年6月期间学习操作的呼吸科医师所进行的前50例EBUS-TBNA操作病例,按操作者曾接受的培训方式分组,对其临床病理资料及基因检测状况进行回顾性分析。结果 本研究共纳入442例患者,其操作者接受模拟器教学232例,接受传统教学210例。两组病例的总体诊断阳性率差异无统计学意义。但对基础疾病为非小细胞肺癌者, 模拟器教学组可完成驱动基因检测的比例明显高于传统教学组(86.8% 对比71.2%,P<0.05)。学习曲线对比亦提示模拟器教学组操作者更早达到技术要求。结论 模拟器教学可提高内镜医生取材进行基因检测的充分性,且可能有助于缩短其培训时间,是一种值得采纳的教学方式。

关键词: 模拟器教学, 超声气管镜针吸活检, 学习曲线, 取材充分性

Abstract: Objective The efficacy of the two teaching methods for EBUS-TBNA was evaluated by comparing the learning curve, diagnostic accuracy, and specimen acquisition for genotyping by operators and so to find a better one for training pulmonologists. Methods The first fifty patients of each operator learning EBUS-TBNA between January 2015 and June 2019 in a single center were retrospective collected and grouped by the operators training methods. The diagnosis, genotyping and clinical characters were reviewed. Results A total of 442 patients were collected and reviewed. There were two training groups: a conventional training group (232 cases) and a simulator assistant training group (210 cases). There was no statistical difference in the diagnostic yield between the groups of trainees. However, specimen from lung cancer patients in simulator training group were more adequate for gene testing than in conventional training group (86.8% vs 71.2%, P<0.05). By comparing the learning curve among the groups, it was found that the trainees in stimulator assistant training group needed less minimum number of operations to achieved proficiency than in conventional training group. Conclusions Simulation-based training is demonstrated to be more efficient in improving the bronchoscopists'skill in terms of getting sufficient specimen for gene testing. Simulation-based training may also shorten the time needed for bronchoscopists'training and can be applied in the EBUS-TBNA training course.

Key words: simulation-based/simulator training, EBUS-TBNA, learning curve, specimen acquisition

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