目的：比较单一EYESi虚拟手术模拟器(Dry-lab)、Wet-lab以及两种方式联合教学在超声乳化白内障吸除显微手术培训中的效果及差异，以期探索更科学高效的教学方式。方法：选取中山大学中山眼科中心接受住院医师规范化培训的1年级住院医师18名，随机分为Dry-lab组、Wet-lab组和联合组，每组各6人，分别接受8次有效Dry-lab训练、8次Wet-lab训练、4次有效Dry-lab训练联合4次Wet-lab训练。培训前后问卷调查评估三种教学方式的模拟效果与学员满意度，并在猪眼模型上考核超声乳化白内障吸除手术的三个主要步骤，以评估学员的培训效果。结果：Dry-lab与Wet-lab训练均能有效帮助学员学习使用显微器械，操作手感较好。但在立体感(P=0.007)、与人眼操作相比近似度(P<0.001)以及对掌握技术的帮助度(P=0.003)上，Wet-lab优于Dry-lab训练；而在缩短培训用时(P<0.001)上，Dry-lab培训更具优势。联合培训模式培训效果优于单一Wet-lab训练(P=0.014)和模拟器培训(P=0.012)，整体满意度高于Wet-lab训练(P=0.042)和Dry-lab培训(P=0.042)。结论：Dry-lab与Wet-lab训练在超声乳化白内障吸除显微手术培训中各有优势，而两者相结合的教学模式更为高效，培训效果更佳，整体满意度高。
Objective: To compare the effects and distinctions among three methods of phacoemulsification training: EYESi simulator (Dry-lab), Wet-lab, and a combined approach, in order to find out more scientific and efficient teaching method. Methods: 18 first-year residents undergoing residency training at Zhongshan Ophthalmic Center, Sun Yatsen University were randomly assigned to three groups: Dry-lab, Wet-lab, and Combined. Each group, consisting of 6 individuals, underwent a specific training regimen—8 sessions of effective simulator training for the Dry-lab group, 8 Wet-lab sessions for the Wet-lab group, and a combination of 4 effective simulator sessions with 4 Wet-lab sessions for the Combined group. The questionnaires were administered to assess simulation effects and student satisfaction before and after each training sessions. Additionally, the training effects were recorded in the three main steps of phacoemulsification cataract extraction surgery on a pig eye model. Results: Both the EYESi simulator and Wet-lab were proved to be effective in facilitating the learning of microscopic instrument use with commendable operating experience. However, Wet-lab is superior to the virtual simulator in terms of stereoscopic sensation (P=0.007), similarity to the human eye (P<0.001), and assistance in mastering techniques(P=0.003). Simulator training is found to be more advantageous in shortening the overall training time (P<0.001). The training effect of the joint training mode is better than that of single Wet-lab training (P=0.014) and simulator training (P=0.012), and the overall satisfaction is higher than that of Wet-lab training (P=0.042) and simulator training (P=0.042). Conclusion: The EYESi virtual surgery simulator and Wet-lab training have their advantages respectively in training for phacoemulsification cataract extraction microsurgery, and the combined teaching mode is more efficient, with better training effects and overall satisfaction.
目的：比较轻、中、重度近视患儿之间的视觉功能的差异，探索虚拟现实下的短期可塑训练对近视视觉功能的改善效果。方法：选择2022年6月—2022年9月就诊于苏州大学附属儿童医院的6~16岁儿童102例，按照屈光度分为正常对照组、轻度近视组和中重度近视组，进行眼科常规检查和视知觉功能检查，并进行视觉短期可塑训练。结果：近视患儿存在立体视功能缺损，近视程度与精细立体视功能损害呈正相关，各组之间比较差异具有统计学意义(P<0.05)，部分患儿存在中心凹抑制。训练后，轻度近视组的中距离精细立体视功能得到改善，比较差异具有统计学意义(P<0.05)。结论：近视患儿存在立体视功能异常和中心凹抑制，且立体视功能的损害随着近视程度的增加而加重。轻度近视患儿部分精细立体视功能经过虚拟现实短期可塑训练可得到改善，而中重度近视患儿精细立体视功能改善不明显。
Objective: To compare the difference of visual function among children with myopia in different diopter, and explore the effect of short-term plastic training of virtual reality on visual function improvement. Methods: The 102 children aged 6-16 years who admitted to Children's Hospital of SoochowUniversity from June 2022 to September 2022 were recruited and divided into control group, mild myopia group and middle and high myopia group according to diopter. Routine ophthalmologic examination and visual perception function examination were carried out, and short-term plastic training was implemented. After the training, visual perception function examination was completed again. Results: There were significant differences in stereoscopic function defect at different distances among myopic children, a negative correlation between myopia and stereoscopic function was found. while there were several cases have foveal suppression. After training, the fine stereopsis at medium distance of the mild myopia group was significantly improved with significance statistical difference. Conclusions: Myopia can lead to the abnormality of stereopsis and foveal suppression in children. The defect of binocular visual function increases with the increase of myopia. Short term plastic training of virtual reality can partially improve the fine stereoscopic function of mild myopia children whileshowsnosigni ficanceimprovementof the fine stereoscopic function in middle and high myopia group.
目的：探讨眼科临床指南结合团队式学习(team-based learning,TBL)教学课程在眼科住院医师规范化培训中的应用及教学效果。方法：本研究选取2022年1月—2023年6月在广州医科大学附属第一医院眼科进行住院医师规范化培训的15名住院医师作为研究对象，先后交替使用自学讲课、TBL教学这两种教学模式进行眼科临床指南学习，通过填写满意度调查问卷及评估出科考通过率、学业水平测试成绩、结业考通过率，从主观及客观角度探讨临床指南结合TBL学习模式的教学效果。结果：住院医师对增加眼科临床指南学习具有较高评价，且不认为会增加其学习负担。开展指南学习后，住院医师出科考试及格率、学业水平测试通过率、结业考通过率均为100%。在培养团队合作能力、改善学习氛围两方面，TBL讲课的满意度均高于自学讲课(均P＜0.001)。93.3%(14/15)的住院医师更喜欢TBL教学模式。结论：眼科临床指南结合TBL教学是一种有效的教学模式，住院医师在主观满意度调查问卷及客观考试成绩的评估中，均达到满意的教学效果。
Objective: To investigate the application and teaching effect of clinical guidelines combined with team based learning(TBL) teaching courses in standardized training for ophthalmic residents. Methods: 15 residents who received standardized training in the ophthalmology department of the First Affiliated Hospital of Guangzhou Medical University were recruited from January 2022 to June 2023. Self-study teaching and TBL teaching were successively applied to teach the clinical guidelines of ophthalmology. The subjective and objective teaching effects were evaluated by satisfaction questionnaire, passing rate of phase examination, achievement of academic proficiency test and passing rate of final examination. Results: The clinical guidelines enjoy the high opinion in the residents, and would not be strengthen their learning burden. After the residents studied clinical guidelines, their passing rate of the phase exam, academic proficiency test and final examination were all 100%. In terms of cultivating teamwork ability and study atmosphere, the satisfaction of TBL lectures was significantly higher than that of self-study lectures (P< 0.001). 93.3% (14/15) of the residents preferred TBL lectures. Conclusions: The combination of ophthalmology clinical guidelines and TBL teaching was proved to be an effective teaching model. The residents achieved excellent teaching results in the subjective satisfaction questionnaire and objective examination scores.
目的：探讨眼科住院医师规范化培训中睑板腺囊肿诊疗的培训效果及存在的问题，以期改进培训方式。方法：以2020年4月在中山大学中山眼科中心培训的154名学员为对象，进行问卷调查，采用SPSS 20.0统计学软件进行数据分析。结果：共76名专业型硕士(专硕)、78名住院医师培训(住培)学员完成了问卷调查。专硕具有睑板腺囊肿诊断、保守治疗及手术主刀经验的比例分别为40.8%、11.8%、7.9%；住培则显著高于前者，分别为79.5%(P<0.001)、60.3%(P<0.001)和21.8%(P=0.016)。对于关键诊疗环节的判断，90.8%的专硕选择了临床诊断(P=0.007)，94.9%的住培则选择治疗方案(P<0.001)。去除囊壁、术中意外与破溃皮肤的处理是专硕难以掌握的手术步骤(P<0.001)；而住培仅为去除囊壁(P<0.001)。结论：睑板腺囊肿诊疗水平在眼科住院医师规范化培训中亟待提高，并根据各类型学员的临床能力和认知差异，进行分级分类培训。
Objective: To explore the teaching effect of diagnosis and treatment on chalazion in the standardized training of ophthalmology residents and its existing problems, in order to improve the quality of the training systems. Methods: A self-designed questionnaire survey was conducted with 154 ophthalmology residents in Zhongshan Ophthalmic Center in April 2020, and the investigative data was analyzed using SPSS 20.0. Results: Totally 76 medical postgraduates and 78 ophthalmology residents completed the questionnaire survey. The proportions of medical postgraduates who had individual experience on diagnosis, conservative and surgical treatment of chalazion were 40.8%, 11.8%, and 7.9%. Compared to the former, ophthalmology residents had significantly higher proportion, with 79.5% (P<0.001), 60.3% (P<0.001), and 21.8% (P=0.016), respectively. For judging the important aspect of diagnosis and treatment process, the medical postgraduates chose the clinical diagnosis (90.8%) (P=0.007), while the ophthalmology residents paid more attention on treatment options (94.9%) (P<0.001). In the surgical procedures, removal of cyst wall, management of intraoperative accidents and skin ulcers are all their difficult skills to master for medical postgraduates (P<0.001), while only removal of cyst wall for residents (P<0.001). Conclusion: The training level of diagnosis and treatment of chalazion still needs to be improved in the standardized training of ophthalmology residents. The training should be carried out according to the clinical competence and cognition differences of various types of students.
目的：构建具有较强科学性和实用性的眼科专科护士培训体系，为眼科专科护士的准入、培养、考核提供理论基础。方法：通过查阅文献、焦点小组和专家会议法，拟定眼科专科护士培训体系的课程、带教、评价体系。结果：构建的眼科专科护士培训体系内容包括课程体系、培训过程、临床实践指标、考核评价方法4个部分。其中，课程体系部分包含一级指标5项，二级指标11项，三级指标55项；培训过程包括一级指标4项、二级指标12项；临床实践指标包括一级指标6项、二级指标23项；考核评价方法包括一级指标5项、二级指标10项。结论：眼科专科护士培训体系构建过程科学，内容设置合理，对开展专科护士培训具有较好的指导意义。
Objective: To develop a scientific and practical training system for ophthalmic specialist nurses and provide theoratical basis for the the admission, training and assessment of ophthalmic specialist nurses. Methods: Through extensive review of domestic and foreign literatures, a focus group interview and an expert meeting, the curriculum, teaching and evaluation system of the ophthalmic specialist nurses training system was developed.Results: The training system for ophthalmic specialist nurses consists of four parts: training content, training process, clinical practice, assessment and evaluation. Among them, the training content includes 5 first-level indicators, 11 second-level indicators and 55 third-level indicators. The training process of ophthalmic specialist nurses includes 4 indicators of the first level and 12 indicators of the second level. The clinical practice indexes of ophthalmic specialist nurses include 6 indexes of the first grade and 23 indexes of the second grade. The methods of assessment and evaluation of ophthalmic specialist nurses include 5 indicators of the first level and 10 indicators of the second level. Conclusion: The scientific process and reasonable content of the training system for ophthalmic specialist nurses have a good guiding significance for the training of ophthalmic specialist nurses.
目的：探讨以岗位需求为导向的培训模式在眼科手术室护士上岗前消毒供应专科专项培训中的应用效果。方法：手术室上岗前护士共44名，按随机分配原则，其中23名为实验组，另外21名为对照组。实验组以医院消毒供应中心三大行业标准和医院消毒技术规范为理论依据，以手术室护理岗位需求为目标，制定针对性培训内容，采用多方式培训方法，在消毒供应中心培训3个月考核合格后调入手术室。对照组直接调入手术室工作。采用手术室带教老师对新上岗护士满意度调查作为评价指标。结果：23名学员的理论知识考核、技术操作考核全部合格，小讲课顺利完成。手术室带教老师对实验组的满意度明显高于对照组。结论：建立以岗位需求为导向的眼科手术室护士消毒供应专科培训模式，有助于提高新上岗的手术室护士工作适应性，并提升手术室护士对专科器械的管理能力。
Objective: To explore the application effect of job demand-oriented training model in specialized training of sterile supplying for nurses in the ophthalmic operation room. Methods: A total of 44 nurses who would work in the operating room were randomly divided into the experimental group (n=23) and control group (n=21). Based on the three industrial standards of Central Sterile Supply Department (CSSD) and the technical specifications of disinfection in hospital, and targeting the job requirements of operating room nursing, the experimental group formulates specific training contents and adopts various training methods. The experimental group was transferred to the operating room after being trained in CSSD for 3 months and passing the examination. The control group was transferred directly to the operating room. The degree of satisfaction from the teachers of operating room to new nurses was used as the evaluation index. Results: All the 23 students passed the examination of theoretical knowledge and technical operation, and the small lectures were completed successfully. The degree of satisfaction from teachers in operating room to trainees was obviously higher than that of untrained nurses. Conclusion: The establishment of job demand-oriented training model in specialized training of sterile supplying for nurses in ophthalmic operation room is helpful to improve the work adaptability of the newly-hired nurses in the operation room. It also helps the nurses in the operation room to enhance the management ability on the specialized instruments.
目的：探讨急救护理技能规范化培训考核在眼科护士中的应用效果。方法：对暨南大学附属深圳眼科医院142名眼科护士实施急救护理技能的规范化培训考核，比较培训前后急救理论考核成绩及急救技能操作考核成绩的差异，并采用自制调查问卷进行培训评价的调查。结果：在实施急救护理技能规范化培训后，眼科护士的急救理论与技能操作考核成绩均高于培训前，差异有统计学意义(P<0.05)；90%以上的眼科护士对急救培训持肯定意见。结论：急救护理技能规范化培训考核提高了眼科护士的临床急救护理水平，培养了良好的急救护理意识和团队协作精神，同时增加了护士的自我价值及职业认同感，获得了较好的培训效果。
Objective: To explore the application effect of standardized training and assessment of emergency nursing skills in ophthalmology nurses. Methods: We implemented standardized training and assessment of emergency nursing skills for 142 ophthalmology nurses in our hospital, compared the difference between the first aid theory and the first aid skill operation before and after the training, and used a self-made questionnaire to conduct training evaluation surveys. Results: After implementing the standardized training of emergency nursing skills, the assessment scores of first aid theory and skill operation of ophthalmology nurses were higher than those of the pre-training assessment. And the difference was statistically significant (P<0.05). More than 90% of ophthalmology nurses had a positive opinion on first aid training. Conclusion: Standardized training and assessment of emergency nursing skills have improved the clinical emergency nursing level of ophthalmology nurses and cultivated a good emergency nursing awareness and teamwork spirit. At the same time, they have strengthened nurses’ self-worth and professional identity, and achieved better training results.
目的：调查引导式教育训练对视力障碍学生生活质量的影响。方法：前瞻性随机对照临床研究。选取2020年在泉州特殊教育学校就读视力障碍学生，按照入组条件随机分为引导式教育训练组和对照组，引导式教育训练组进行引导式教育训练，对照组进行常规康复训练。采用中文版低视力者生活质量量表(Chinese-version low vision quality of life questionnaire，CLVQOL)评估视力障碍学生的基线和训练3个月的生活质量，并进行比较分析。结果：72例视力障碍学生全部完成了基线和随访时的生活质量问卷调查。进行基线检查时，各组CLVQOL评分总分差异无统计学意义(P>0.05)。3个月后，各组CLVQOL评分总分均增加，引导式教育训练组从基线59(48.5，80.5)上升到105(97.5，119.5)，差异有统计学意义(Z=?4.781，P<0.001)；对照组从基线69(56，85)上升到106(80，112)，差异有统计学意义(Z=?4.438，P<0.001)；引导式教育训练组在CLVQOL评分总分(P=0.021)及阅读和精细工作维度(P=0.004)、日常生活能力维度(P=0.003)的评分差值均高于对照组。结论：引导式教育训练是一种重要的低视力康复训练方法，可以明显提高患者的生活质量。
Objective: To investigate the effect of conductive education training on the quality of life in visually impaired students. Methods: It was a prospective randomized controlled trial. The visual impairment students who had registered in Quanzhou Special Education School in 2020 were selected and randomly divided into two groups: conductive education training group and control group. The conductive education training group received conductive education training, while the control group received routine rehabilitation training. Chinese version low vision quality of life questionnaire (CLVQOL) was used to assess the quality of life of low vision students at baseline and 3 months after training, and comparative analysis was conducted. Results: All 72 students with visual impairment completed CLVQOL surveys. At baseline, there was no significant difference in total CLVQOL scores between groups. After 3 months, overall CLVQOL scores increased in both groups, from baseline 59 (48.5, 80.5) to 105 (97.5, 119.5) in the conductive education group (Z=-4.781, P<0.001), and 69 (56, 85) to 106 (80, 112) in the control group (Z=-4.438, P<0.001). The total score of CLVQOL (P=0.021), reading and fine work subscale (P=0.004), and daily activities subscale (P<0.003) in the conductive education training group were higher than those in the control group. Conclusion: Conductive education training is an important method of low vision rehabilitation training, which can significantly improve the quality of life of patients.
眼科住院医师规范化培训(以下简称“规培”)是培养眼科医师的必要环节。我国规培模式日臻成熟，但眼科规培过程管理中仍存在诸多问题，包括专科医院和综合医院的规培协调问题、师资激励、规培学员类型多样、研究生和规培“双轨制”、如何开展显微手术技能培训等，很多具体方案和措施仍在摸索中。眼科专科医院学科体系建设相对完善，配备更充足的教学资源，有一定的规培经验，是眼科规培的主力军。汕头国际眼科中心结合国家要求创建了一套规培模式，注重规范化、标准化和个性化相结合，并通过借鉴香港及海外住院医师培训经验，丰富理论培训形式，优化操作培训环境，突出外语和科研能力训练，强调系统性临床思维。本文基于汕头国际眼科中心五年来开展眼科规培的实践经验与思考，总结当前眼科专科医院规培现状，并提出对策和建议。
Standardized training for ophthalmology residents is an essential stage during the development of ophthalmologists. The standardized training system has become more and more mature, while problems still exist in the aspects of coordination between specialized hospitals and general hospitals, teacher resources, unevenness of trainees, combination of postgraduate education and residency standardized training, microsurgical skills training, and so on. Therefore, programs and strategies of standardized training are still under exploration. Eye hospitals, with the excellent disciplinary system, adequate resources, and advanced experience, play a key role in standardized training for ophthalmology residents. Joint Shantou International Eye Center has set up a training model in accordance with national requirements, focusing on the combination of standardization, normalization, and individuation. Besides, by learning from the oversea experience of residents training, Joint Shantou International Eye Center has enriched the training forms, optimized the skill training environment, and highlighted the training of foreign language, scientific research, and systematic clinical thinking. This paper, based on the 5-year experience and reflection on standardized training for ophthalmology residents in Joint Shantou International Eye Center, summarizes the current status of standardized training and put forward some measures and suggestions.
眼科住院医师规范化培训(住培)是眼科后备医疗人才培养中极其重要的环节，但反观目前我国眼科住培体系，尚存诸多不足。笔者以所在眼科住培专业基地运行为例，拟评估住院医师临床带教内容、带教模式和带教效果，以及加强规培学员思政教育及对带教老师授课能力的培训等方面进行较为全面的改革，并对此项改革所取得的成效进行报告，以期对我国眼科住院医师规范化培训模式的探索和完善提供帮助，提高我国眼科规培基地质量，为眼科发展培养更多优秀的后备人才。
The standardized residency training is the essential prerequisite for the training of ophthalmologists in the health system. Based on the emerging problems of standardized residency training in the Department of Ophthalmology in Wuhan Union Hospital, attempts have been made to explore the effectiveness of a comprehensive reform of clinical instruction in areas of content, mode and learning evaluation for residents, as well as incorporating ideological and political elements in the instructional process and faculty training to enhance teaching skills for instructors, which has achieved good results. We hope that the dissemination of such efforts could provoke thoughts on improving the training model for ophthalmological residents and to improve the quality of the ophthalmological training programs in China, and to eventually lead to accumulation of better ophthalmologists in China.
