摘要
目的评估角巩膜裂伤缝合评分量表在眼科住院医师手术技能培训中应用的可行性。方法研究对象为我院2019级和2020级参加住院医师规范化培训眼科专业的53名住院医师,评分者为3名具有高级职称的眼科带教医师,培训之前2名评分者应用角巩膜裂伤缝合评分量表对各项目进行评分,应用Kappa检验检测其一致性,应用t检验比较住院医师培训前后各项目的评分差异。通过问卷调查了解学员及评分者对评分量表的改进意见。结果评分量表中的10个项目中有9项的一致性为良好,一致性较高的项目为“正确识别和使用手术器械”“正确调节和使用显微镜”和“正确选择眼科显微缝线”,Kappa值分别为1.00、0.96和1.00,差异有统计学意义(P<0.01)。较低的项目为“缝线针距”“角膜缝线埋藏”和“缝线跨度”,Kappa值分别为0.58、0.64和0.74,差异有统计学意义(P<0.01)。住院医师培训后手术评分较培训前各项目及总分均有显著提高,培训后总分(48.6±2.10)分,较培训前总分(39.03±5.93)分显著提高,差异有统计学意义(P<0.01)。3名评分者均对评分量表能反映住院医师的手术能力表示同意。结论角巩膜裂伤缝合评分量表可作为眼科住院医师显微缝合技能培训的标准化考核评估工具。
Objective To evaluate the feasibility of the newly developed corneoscleral laceration suture score scale in the surgical skill assessment of ophthalmic residents.Methods The study enrolled 53 ophthalmic residents who entered our hospital from 2019 to 2020.The scorers were 3 ophthalmic teachers with senior professional titles.Before the training,the two scorers used the corneoscleral laceration suture score scale to score each item,and the Kappa test was used to measure the consistency.T-test was used to compare the differences in the scores of the residents before and after the surgical training.Results The consistency of 9 items in the 10 items in the scoring scale was good.The items with higher consistency were the"correct use of the surgical instruments","correct adjustment and use of microscopes"and"correct selection of ophthalmic microsutures",Kappa values being 1.00,0.96 and 1.00,P<0.01.Relatively lower items were the"distance between two stitchs","burying knots"and the"distance between suture entry and exit",Kappa values being 0.58,0.64 and 0.74,P<0.01.The scores of each item and the total score of the residents after training were significantly improved compared to those before the training,the total score before and after training being(39.03±5.93)vs(48.6±2.10),P<0.01.Conclusion The corneoscleral laceration suture score scale can be applied as a standardized assessment tool for the training of microsurgery skills of ophthalmologists.
作者
严茜茜
江双红
苏钰
袁静
陈长征
Yan Xixi;Jiang Shuanghong;Su Yu;Yuan Jing;Chen Changzheng(Eye Center,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)
出处
《中国毕业后医学教育》
2022年第4期353-357,共5页
Chinese Journal of Graduate Medical Education
基金
武汉大学医学部教学改革研究项目(2020032)。
关键词
住院医师
手术培训
评分量表
眼科
resident
surgical training
scoring scale
ophthalmology
