在美国密歇根大学医学院,21世纪的教育技术已经紧紧跟上了21世纪的医学:受训医生可以在高度模拟现实的模拟装置上练习手术技能。
传统的外科训练是通过一种学徒形式完成的:在数年时间里,训练有素的高年资外科医生在手术室里指导住院医生。而临床模拟中心(The Clinical Simulation Center)则能够模拟进行真实外科手术时的情景,甚至能够模拟手术操作时候的那种感觉,从而允许受训的外科医生在接触手术室之前就能够学习练习手术技能。
例如,住院医生在接受结肠镜检查的培训时,在屏幕上就可以看到结肠镜的实时移动以及空气注入的情景。他们能够学习肠粘膜活检、烧灼、甚至肠息肉套扎术。如果他们操作用力过大或者患者麻醉深度不够,模拟的患者会提醒操作者(通过话筒)控制麻醉深度(比如:哎唷!痛呀!嗨!)
U-M手术科教育副主席Paul Gauger说:“我们努力提高对患者检查和手术的安全性以及对患者的护理质量。同时,我们也关注医生的教育过程以及资格保证。而我们临床模拟中心的高科技手段能够帮助我们达到这些目标。”
Gauger说,临床模拟中心致力于为受训医生提供各种各样临床上的困难环境,而且根据需要提供学习机会。这些高科技手段会帮助医学院培训出更好的医生吗?这些高科技手段有助于改善患者的疾病转归吗?为了回答这些疑问,临床模拟中心正在评估中心的教育和学习水平;同时也为了帮助其他中心确定如何更好地利用模拟技术。
Extremely Realistic: Learning with Virtual Surgery Simulators
At the University of Michigan Medical School, 21st century educational technology has caught up with 21st century medicine: Doctors-in-training can practice their skills on extremely realistic simulators. Traditional surgical training is done through a type of immersive apprenticeship, with experienced surgeons teaching residents in the operating room over a period of years. The Clinical Simulation Center mimics the look - and even the feel - of performing an actual surgical procedure, allowing surgical trainees to practice techniques before they ever reach the operating room. For instance, a resident training on the colonoscopy simulator looks at a screen with real time response to scope movements and air insufflation. They have the ability to perform mucosal biopsies, cautery and even snaring polyps. And if they push too hard or use too little sedation, the simulated patient reminds them (through the speakers) to manage the anaesthesia appropriately (I.e., ouch, ow, or hey). We're working to enhance patient safety and the quality of patient care. At the same time, we're dedicated to the process of education and the assurance of competency, so the advanced technologies in our Clinical Simulation Center help us to meet all these goals,” says Paul Gauger, associate chair for education, U-M Department of Surgery. He notes that the Clinical Simulation Center works to prepare doctors-in-training for a wide variety of difficult situations. The Clinical Simulation Center provides learning opportunities on demand, Gauger says. Will this technology help medical schools to train better doctors? And, will the technology help improve patient outcomes? The Clinical Simulation Center is evaluating the level of learning that takes place at the Center in order to answer these questions and help other centres determine how best to use simulation technologies. |