Simulation-based training in ear, nose and throat skills and emergencies

Abstract Objectives: The aim of the study was to compare lecture-based teaching and simulation-based hybrid training for ENT induction and objectively assess the performance of trainees in a simulated environment. Methods: This is a prospective interventional study that included 60 interns in their rotatory internship with no prior exposure to ENT emergencies. The interns came in batches of 5–6 for their 15-days ENT postings. On the first day, a pre-test questionnaire, lecture-based teaching on three scenarios and then allocation into one of the three simulation groups- Group A (Tracheostomy group), Group B (Nasogastric tube group), and Group C (Epistaxis group) was done. Hands-on simulation training was given only to the assigned group. At the end of 15-days, post-test questionnaire and an objective assessment of the three scenarios in a simulated environment was conducted. The same training was repeated for each batch of participants who attended the posting. Results: The participants had significant improvement in the post-test scores in all three scenarios (p < 0.05), and these improvements were marked in those who had received simulated training. On comparing simulation scores, the participants who received hands-on training on a particular scenario outperformed other (p < 0.05). Conclusion: Simulation-based training improves cognition and overall confidence in managing ENT skills and emergencies. In simulation training, objective and standardized assessment is the key to achieve specific learning objectives to improve the psychomotor and cognitive skill. Level of evidence: II.

摘要 研究目的：本研究旨在对比基于授课式教学与基于模拟的混合培训在耳鼻喉科（ENT）急诊操作培训中的应用效果，并客观评估受训者在模拟环境中的操作表现。
方法：本研究为前瞻性干预性研究，纳入60名尚未接触过耳鼻喉科急诊操作的轮转实习医生。实习医生以5至6人为一组，参与为期15天的耳鼻喉科轮转。首日流程如下：填写预测试问卷、开展针对3种临床场景的授课式教学，随后将受试者分配至3个模拟培训组之一——A组（气管造口术组）、B组（鼻胃管置入组）及C组（鼻出血组）。仅对分配至对应组的受试者实施针对性实操模拟培训。15天轮转结束后，统一开展后测试问卷调研，并在模拟环境中对3种场景的操作进行客观评估。该培训流程将针对每一批次参与轮转的受试者重复实施。
结果：所有3种场景的后测试得分均较预测试有显著提升（p<0.05），且接受模拟培训的受试者提升幅度更为显著。对比模拟操作得分可知，针对特定场景接受过实操培训的受试者，其表现显著优于未接受该场景培训的受试者（p<0.05）。
结论：基于模拟的培训可提升受训者处理耳鼻喉科技能与急诊情况的认知水平与整体自信心。在模拟培训中，客观且标准化的评估是达成特定学习目标、提升受试者精神运动与认知技能的关键。证据等级：II级。