背景:眼眶室综合征是一种潜在的致盲眼病。及时的诊断和治疗对于优化视觉结果至关重要。对于急诊医师和眼科医生来说,横切角是明确的治疗方法,也是必需的能力。对手术缺乏信心会导致延迟治疗和不良结果。
目标:我们的目标是创建一个低成本,现实的,模拟模型,以确保受训者有信心在进行外侧角切开术和角切开术。
方法:使用急诊科的设备创建了一个模型。使用教学前和教学后问卷评估了该模型的有效性,该问卷测量了学习者的自我感知信心。
结果:47名急诊医学和18名眼科注册人员使用5分利克特量表(1=不太自信,5=极度自信);42%(n=27)的参与者感到“相当自信”(李克特量表4)在教学结束后的几个小时内无人监督地进行该程序,与之前的9.23%(n=6)相比(p<0.01)。我们的模型导致所有三种置信度测量值均显着增加(诊断眶室综合征,定位必要的设备并进行角囊切开术和角囊溶解术),被评定为4.35(1=完全没有帮助,5=非常有帮助)在理解该区域的解剖结构方面。66%(n=43)的参与者表示他们希望进一步的模拟教学。
结论:我们的模型成本低,易于组装,解剖学上是正确的。用户可以在不切割下盖的情况下,“拉拔”下肌腱,欣赏角囊切开术和角囊溶解术的区别。使用此模型显着增加了对执行该程序感到“相当有信心”的学习者数量。眼科和急诊医学的学员应考虑使用此模型。
BACKGROUND: Orbital compartment syndrome is a potentially blinding eye condition. Timely diagnosis and treatment are paramount to optimize visual outcomes. Lateral canthotomy and
cantholysis is the definitive management and a required competency for emergency physicians and ophthalmologists. Lack of confidence in the procedure can result in delayed treatment and poor outcomes.
OBJECTIVE: Our aim was to create a low-cost, realistic, simulation model to ensure trainees were confident in performing lateral canthotomy and
cantholysis.
METHODS: A model was created using equipment found in the emergency department. This model\'s efficacy was assessed using pre- and post-teaching questionnaires measuring learner\'s self-perceived confidence.
RESULTS: Forty-seven emergency medicine and 18 ophthalmology registrars rated their confidence in the procedure using a 5-point Likert scale (1 = not very confident, 5 = extremely confident); 42% (n = 27) of participants felt \'quite confident\' (4 on Likert scale) in carrying out the procedure unsupervised out of hours after the teaching session, compared with 9.23% (n = 6) before (p < 0.01). Our model resulted in significant increases in all three measures of confidence (diagnosing orbital compartment syndrome, locating the necessary equipment and performing canthotomy and
cantholysis) and was rated as 4.35 (1 = not at all helpful, 5 = extremely helpful) in understanding the anatomy of the region. Sixty-six percent (n = 43) of participants stated they would like further simulation teaching.
CONCLUSIONS: Our model is low cost, easy to assemble, and anatomically correct. The user can \'strum\' the inferior canthal tendon without cutting the lower lid, appreciating the difference between canthotomy and
cantholysis. Use of this model significantly increased the number of learners who felt \"quite confident\" with performing the procedure. Use of this model should be considered for trainees in ophthalmology and emergency medicine.