首页|耳内镜与显微镜相结合模式在耳科规范化培训中的应用分析

耳内镜与显微镜相结合模式在耳科规范化培训中的应用分析

Application of combined endoscopy and microscopy in standardized otology training

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目的 分析耳内镜和耳显微镜相结合的教学模式在耳科规范化培训中的应用效果,提高培养耳科医师的教学效率.方法 选取2022年1月-2023年12月在中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科医学部进行规范化培训且没有耳科临床工作经验的33名学员进行耳科问卷调查,该问卷为作者自制问卷,内容包括:耳内镜、耳显微镜的学习时长,对耳科11项知识点的自我评价,对耳内镜学习和显微镜学习重要性的主观评价等.结合学员的耳科轮转结业考试成绩,分析耳内镜和耳显微镜教学的应用效果.结果 33份问卷共收回问卷29份,去除耳科培训尚未结束的5名,共有24名纳入调查研究,男10名,女14名,年龄23~36(27.8±4.1)岁.自我评价量表信度分析Alpha值为0.905.耳科闭卷考试的成绩为(93±2)分,均通过了耳科培训考试.24名学员对耳内镜教学和耳显微镜教学的重要性评分比较,差异无统计学意义(Z=-1.273,P=0.203).Spearman相关性分析结果显示,24名学员耳内镜学习时长与中耳通气引流的主观评估呈正相关(r=0.502,P=0.012),耳显微镜学习时长与咽鼓管的结构功能、中耳胆脂瘤的病理生理、中耳胆脂瘤的治疗方案的主观评估呈正相关(r=0.456、0.528、0.455,P=0.025、0.008、0.026).耳显微镜学习时长与耳科闭卷考试成绩呈正相关(r=0.494,P=0.014).耳科知识点的学习情况主观评分排在前列的有中耳胆脂瘤的治疗、中耳炎的治疗、中耳胆脂瘤的病理生理、中耳炎的病理生理等.结论 内镜与耳显微镜结合的教学方式可以提高学员的耳科学习效率,为耳科规范化培训提供高效良好的教学资源.
Objective To report application of combined endoscopy and microscopy in standardized otology training to improve training outcomes.Methods Questionnaires were designed by the authors and sent to 33 trainees trained from January 2022 to December 2023 ata the Senior Department of Otolaryngology Head and Neck Surgery,Chinese PLA General Hospital.Coverage of the questionnaires included duration of training with endoscopy or micros-copy,self-assessment of 11 key knowledge points in otology,opinions on the importance of endoscopy and microscopy,etc.Together with final exam scores at the end of training,efficacies of endoscopy and microscopy training were evalu-ated.Results Twenty nine trainees returned the questionnaires,with 24 answering all questions,male=10,female=14,age=23~36(27.8±4.1 years).The Alpha value of the questionnaire was 0.905,indicating good reliability.The exam scores was 93±2,with all trainees passing the exam.There was no difference among the trainees regarding the impor-tance of endoscopy and microscopy(Z=-1.273,P=0.203).Duration of training was positively correlated to understand-ing of the importance of middle ear ventilation(r=0.502,P=0.012),and understanding with Eustachian tube anatomy and function,pathophysiology and treatment of cholesteatoma(r=0.456,0.528,0.455,P=0.025,0.008,0.026),as well as exam scores(r=0.494,P=0.014).Top knowledge points by self-assessment included treatment of cholesteatoma,treat-ment of otitis,pathophysiology of cholesteatoma,pathophysiology of otitis,etc.Conclusion Training involving a combi-nation of endoscopy and microscopy improves training efficacy and is an important resource in standardized otology training.

standardized training for specialistsotologyendoscopemicroscopemiddle ear

刘娅、王方园、邹世桢、侯昭晖

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中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科医学部(北京 100048) 听觉与平衡觉全国重点实验室 国家耳鼻咽喉疾病临床医学研究中心 聋病教育部重点实验室 聋病防治北京市重点实验室

专科医师培训 耳科 耳内镜 显微镜 中耳

2024

中华耳科学杂志
解放军总医院耳鼻咽喉科研究所

中华耳科学杂志

CSTPCD北大核心
影响因子:0.954
ISSN:1672-2922
年,卷(期):2024.22(2)
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