目的:探讨三维可视化及虚拟手术在肝脏外科临床教学中的应用价值.方法:选取复旦大学医学院2012级五年制临床医学本科医学生60名为研究对象,随机分为传统教学组(n=30)和三维教学组(n=30).传统教学组采用肝脏解剖/手术图谱、肝脏模具及手术视频进行肝脏临床解剖及手术教学;三维教学组实习生采用肝脏三维可视化模型、虚拟手术系统及案例对应手术视频进行教学.学习周期为6个学时.学习结束后,对两组学生进行标准化考试考核比较,并调查学生对教学法的评价.结果:三维教学组学生的考试成绩为(95.5±3.1)分,优于传统教学组的(81.0±4.1)分,差异有统计学意义(P＜0.001);三维教学组的优秀率(93.3％)显著高于传统教学组(40％),差异有统计学意义(P＜0.001).问卷调查结果显示,三维教学组所有学生均认为该教学法易于掌握,生动有趣,能调动学习积极性、促进知识的掌握和应用、提高学习效率,并有助于增强自学能力.结论:基于三维可视化及虚拟手术的临床实习带教效果优于传统教学,可有效提高教学质量,值得推广.%Objective:To explore the application value of three-dimensional visualization and virtual surgery system in liver surgery teaching.Methods:A total of 60 undergraduate interns from Fudan University School of Medicine,Grade 2012,were randomly divided into traditional teaching group (n=30) and three-dimension teaching group (n=30).The atlas of liver anatomy and liver surgery,liver model and operation video were used for teaching in traditional teaching group;the three-dimension reconstruction of liver model,virtual liver surgery system and operation video corresponding to real case were used for teaching in three-dimension teaching group.Standardized examination was given 6 class hours later and the questionnaire was used to investigate the students' evaluation for the teaching methods.Results:The exam score of three-dimension teaching group (95.5±3.1) was significant higher than that of traditional teaching group (81.0±4.1,P＜0.001).The excellence rate in three-dimension teaching group (93.3％) was also significant higher than that in traditional teaching group (40％,P＜ 0.001).According to the questionnaire,the new teaching method was valued by all the students in three-dimension teaching group to be easy,vivid and interesting,which could arouse the learning enthusiasm,promote the mastery,improve the learning efficiency and strengthen the self-study ability.Conclusions:Novel clinical teaching using three-dimensional visualization and virtual surgery system is superior to traditional teaching in liver surgery teaching and is recommended for wide application.
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