Application of PBL oriented teaching mode in standardized ECMO training

doi:10.3760/cma.j.issn.1007-1245.2022.18.012

Abstract

Abstract: Objective　To evaluate the effect of problem-based learning (PBL) oriented teaching mode in standardized extracorporeal membrane oxygenation (ECMO) training. Methods　A total of 97 trainees who join our ECMO special training courses were selected by the convenience sampling from September 2020 to March 2022, including 56 males and 41 females, with an age of (33.10±4.67) years old. The PBL oriented teaching mode was adopted in the standardized training courses of theoretical lectures, operation techniques, clinical ward rounds, etc. The trainees' performance before and after training was analyzed. Paired t test was used for statistical analysis. Results　Among them, 82.47% (80/97) of the trainees were from the general intensive care unit (ICU), the proportion of medical and nursing staff was nearly half, 87.62% (85/97) of the trainees had junior and intermediate titles, and 63.92% (62/97) of the trainees had 4-10 years of ICU work experience. The survey showed that most of the trainees hoped to achieve the requirements of independent ECMO preflushing and catheterization [96.91% (94/97)], ECMO transfer [88.66% (86/97)], and long-term operation management of ECMO [93.81% (91/97)] through the training. After 3 months of standardized training, the score of the final examination was significantly higher than that of the pre-training examination [(90.58±8.98) vs. (61.57±15.61)], with a statistically significant difference (t=15.664, P<0.001). Conclusion　PBL oriented teaching mode can effectively improve the effect of standardized ECMO training and is valuable for standardized ECMO training.

Key words: PBL, Extracorporeal membrane oxygenation, Standardized training

摘要： 目的　探讨以问题为基础的学习法（PBL）导向的教学模式在体外膜肺氧合（ECMO）规范化培训中的应用价值。方法　便利抽样法选取2020年9月至2022年3月在广州医科大学附属第一医院接受ECMO专修班全程培训的学员97名，其中男56名，女41名，年龄（33.10±4.67）岁。采用以PBL为导向的教学模式，对理论培训及操作技术、临床查房等进行规范化培训，然后对比分析学员在培训前后的考核成绩。统计学方法采用配对t检验。结果　参加培训的学员82.47%（80/97）来自综合重症监护病房（ICU），医护占比接近各半，初级和中级职称学员占比87.62%（85/97），63.92%（62/97）学员ICU工作经历为4～10年。摸底调查显示，绝大部分学员都表示希望通过培训能达到独立完成ECMO预冲和置管［96.91%（94/97）］、ECMO转运［88.66%（86/97）］、长时间地ECMO运行和管理［93.81%（91/97）］的要求。在结束3个月的规范化培训后，学员结业考试成绩明显高于摸底考试成绩［（90.58±8.98）分比（61.57±15.61）分］，差异有统计学意义（t=15.664，P<0.001）。结论　PBL导向的教学模式，可以有效提高ECMO技术规范化培训的效果，为ECMO技术规范化培训的实施提供一定的参考价值。

关键词: PBL, 体外膜肺氧合, 规范化培训

Xu Yonghao, Sun Qingwen, Zhang Huijin, Li Ronghua, Kong Shaofeng, Chen Lihua, Liu Xiaoqing, Chen Sibei. Application of PBL oriented teaching mode in standardized ECMO training[J]. International Medicine and Health Guidance News, 2022, 28(18): 2571-2575.

徐永昊孙庆文张会锦李荣华孔少烽陈丽花刘晓青陈思蓓. PBL为导向的教学模式在体外膜肺氧合规范化培训中的应用[J]. 国际医药卫生导报, 2022, 28(18): 2571-2575.

References

[1] Jones-Akhtarekhavari J,Tribble TA,Zwischenberger JB. Developing an extracorporeal membrane oxygenation program[J]. Crit Care Clin,2017,33(4):767-775. DOI: 10.1016/j.ccc.2017.07.001.
[2] 侯晓彤. 规范发展体外膜氧合循环辅助支持[J]. 中国体外循环杂志,2018,16(4):193-195. DOI:10.13498/j.cnki.chin.j.ecc.2018.04.01.
[3] 国家卫生健康委办公厅. 体外膜肺氧合(ECMO)技术临床应用管理规范[S].2020-09-01. http://www.nhc.gov.cn/yzygj/s7657/202009/260a018c53ea4dcc911342d89cbe79a4/files/ee54a93740034457adce649666e216c8.pdf.
[4] 杨淳,徐永昊,席寅,等. Workshop教学法在ECMO技能培训中的应用[J]. 医学理论与实践,2020,33(5):850-852. DOI:10.19381/j.issn.1001-7585.2020.05.089.
[5] Endo T, Kagaya Y, Arata Y, et al. Long-term efficacy of an extracorporeal membrane oxygenation simulation with a novel, low-cost vascular model "Endo-Circuit"[J]. Acute Med Surg, 2017, 4(1): 79-88. DOI: 10.1002/ams2.236.
[6] Puslecki M, Ligowski M, Kiel M, et al. Prototype of extracorporeal membrane oxygenation (ECMO) therapy simulator used in regional ECMO program[J]. J Thorac Dis, 2018, 10(8): 5073-5079. DOI: 10.21037/jtd.2018. 07.25.
[7] 胡强,杨九光,高国栋,等. SimMan模拟系统在体外膜肺氧合模拟训练中的应用[J]. 中国体外循环杂志,2018,16(3):139-141,183. DOI:10.13498/j.cnki.chin.j.ecc.2018.03.04.
[8] 童荔,胡文杰,朱艳平,等. 联合教学模式在医护人员体外膜氧合技术培训中的应用研究[J]. 中华医学教育杂志,2020,40(12):1002-1005. DOI:10.3760/cma.j.cn115259- 20200316-00350.
[9] Brum R, Rajani R, Gelandt E, et al. Simulation training for extracorporeal membrane oxygenation[J]. Ann Card Anaesth, 2015, 18(2): 185-190. DOI: 10.4103/0971- 9784.154472.
[10] Burton KS, Pendergrass TL, Byczkowski TL, et al. Impact of simulation-based extracorporeal membrane oxygenation training in the simulation laboratory and clinical environment[J]. Simul Healthc, 2011, 6(5): 284-291. DOI.org/10.1097/SIH.0b013e31821dfcea.
[11] Fehr JJ, Shepard M, McBride ME, et al. Simulation-based assessment of ECMO clinical specialists[J]. Simul Healthc, 2016, 11(3): 194-199. DOI: 10.1097/SIH.0000000000000153.
[12] 李树妹,黄灵坚,李书剑. PBL教学法在临床实践教学中的应用评价与分析[J]. 国际医药卫生导报,2011,17(14):1788-1790. DOI:10.3760/cma.j.issn.1007-1245. 2011. 14.056.
[13] 张爱红. PBL联合案例教学法在中医呼吸内科临床教学中的运用[J]. 中国中医药现代远程教育,2021,19(12):70-71. DOI:10.3969/j.issn.1672-2779.2021.12.026.
[14] 梅鸿. PBL结合CBL教学法在重症医学临床教学中的效果[J]. 中国继续医学教育,2022,14(3):43-47. DOI:10.3969/j.issn.1674-9308.2022.03.012.
[15] 王贵军. PBL联合思维引导在临床教学中的意义[J]. 中国继续医学教育,2022,14(5):85-88. DOI:10.3969/j.issn. 1674-9308.2022.05.023.
[16] 陈英,徐庆梅,张磊. PBL-Seminar结合鲶鱼效应在ICU护士新技术能力培训中的应用[J]. 国际医药卫生导报,2022,28(4):563-568. DOI:10.3760/cma.j.issn.1007-1245.2022. 04.030.
[17] 郑勇军,房贺,水锨崎,等. 混合教学模式在烧伤急救培训中的应用[J]. 现代职业教育,2020(45):62-63.
[18] 王韶双,毕阳,严军,等. 多元化教学在麻醉超声培训中的应用价值[J]. 继续医学教育,2022,36(1):21-24. DOI:10.3969/j.issn.1004-6763.2022.01.006.
[19] Puslecki M, Dabrowski M, Ligowski M, et al. Comprehensive assessment of a nationwide simulation-based course for artificial life support[J]. PLoS One, 16(10): e0257162. DOI: 10.1371/journal.pone. 0257162.
[20] Puślecki L, Dąbrowski M, Puślecki M. Development of innovation cooperation in the time of COVID-19 pandemic[J]. European Research Studies Journal, 2021, Special Issue 1: 1049-1073. DOI: 10.35808/ersj/2087.
[21] Smereka J, Puslecki M, Ruetzler K, et al. Extracorporeal membrane oxygention in COVID-19[J]. Cardiol J, 2020, 27(2): 216-217. DOI: 10.5603/CJ.a2020.0053.
[22] Smereka J, Szarpak L, Filipiak KJ. Modern medicine in the COVID-19 era[J]. Disaster Emerg Med J, 2020, 5(2): 103-105. DOI:10.5603/DEMJ.a2020.0012
[23] Trąpczyński P, Puślecki L, Staszków M. Determinants of innovation cooperation performance: what do we know and what should we know?[J]. Sustainability, 2018, 10(12): 4517. DOI: 10.3390/su10124517.
[24] Weems MF, Friedlich PS, Nelson LP, et al. The role of extracorporeal membrane oxygenation simulation training at extracorporeal life support organization centers in the United States[J]. Simul Healthc, 2017, 12(4): 233-239. DOI: 10.1097/SIH.0000000000000243.
[25] 孙丹丹,梁涛. 柯氏评估模型在医学相关培训中的应用现状[J]. 中华护理教育,2015,12(12):947-949. DOI:10.3761/j.issn.1672-9234.2015.12.017.
[26] 罗云,陈祎,胡星兰,等. 运用柯氏模型构建住院医师规范化培训效果评价指标体系[J]. 中华全科医学,2016,14(12):2113-2115. DOI:10.16766/j.cnki.issn.1674-4152. 2016. 12.044.
[27] 袁路,黄晓琴,张毅,等. 基于柯氏模型的住院医师规范化培训效果研究[J]. 卫生职业教育,2018,36(16):144-146.
[28] 孙亮亮,邹俊杰,郑骄阳,等. 基于柯氏评估模型的住院医师规范化培训评估体系的构建[J]. 中国高等医学教育,2011(12):46-47. DOI:10.3969/j.issn.1002-1701.2011. 12.023.