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：本研究旨在对比讲授式教学与基于模拟的混合培训在耳鼻喉科（Ear, Nose and Throat, 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。
研究方法：本研究为一项前瞻性干预性研究，纳入60名此前未接触过耳鼻喉科急诊相关操作的轮转实习医师。实习医师以5~6人为一组，参与为期15天的耳鼻喉科轮转。入组首日，所有参与者均完成预测试问卷、接受针对3种临床场景的讲授式教学，随后被分配至3个模拟培训小组之一：A组（气管切开术（tracheostomy）组）、B组（鼻胃管（Nasogastric tube）置入组）、C组（鼻出血（Epistaxis）处理组）。仅分配至对应小组的实习医师可接受实操模拟培训。15天轮转结束后，所有参与者完成后测试问卷，并在模拟环境中接受针对3种临床场景的客观评估。该培训流程对每一批次参与轮转的实习医师均重复开展。
研究结果：所有参与者在3种临床场景的后测试得分均显著提升（p < 0.05），其中接受过对应模拟培训的参与者提升更为显著。对比模拟操作得分可见，接受过特定场景实操培训的参与者表现优于未接受该培训的参与者（p < 0.05）。
研究结论：基于模拟的培训可提升实习医师处理耳鼻喉科操作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、提升心理运动技能与认知能力的关键。
证据等级：II级。