基于Miller金字塔理论构建的麻醉情景模拟训练对提升手术室专科护士应急能力的效果研究

Study on the Effect of Anesthesia Scenario Simulation Training Constructed Based on Miller’s Pyramid Theory on Improving Emergency Response Competence of Specialized Operating Room Nurses

摘要: 目的：评价以临床工程师为核心的麻醉情景模拟训练联合Miller金字塔教学法在提高手术室专科护士应急能力与综合能力方面的应用效果。方法：采用随机对照试验设计。选取2023年10月~2025年10月间就职于我院手术室的专科护士100例，按照随机序列法分为观察组、对照组，每组50例。对照组接受常规理论授课与自主学习的传统培训模式；观察组则实施以手术室临床工程师为核心的情景模拟训练联合Miller金字塔教学法综合培训方案，培训周期为6个月。比较两组护士在培训前后应急能力与综合能力得分的变化，以及故障排除导致的手术暂停时长并评估教学满意度与职业认同感。结果：组织教学前，两组专业护士应急能力、综合能力得分接近，差异无统计学意义(P均 > 0.05)。教学过后，观察组专业护士应急能力得分(86.6 ± 7.7)分、综合能力得分(168.1 ± 10.2)分，对照组分别为(76.9 ± 8.4)分、(145.2 ± 9.6)分，两组差异具有统计学意义(t = 6.019, 11.560, P = 0.001, 0.001)。观察组故障排除导致的手术暂停时长(5.12 ± 1.63) min，对照组为(10.15 ± 2.93) min，两组差异具有统计学意义(t = 6.709, P = 0.001)。观察组教学满意度为96.00% (48/50)，职业认同感94.00% (47/50)，对照组分别为82.00% (41/50)、80.00% (40/50)，两组差异具有统计学意义(χ² = 5.005, 4.332, P = 0.025, 0.037)。结论：情景模拟训练加Miller金字塔教学法有助于提高手术室专科护士应急能力、综合能力，也能提升其对教学工作的认同感、职业认同感，缩短故障排除导致的手术暂停时长，是一种值得推广的系统化临床培训模式。

Abstract: Objective: This paper aims to evaluate the application effect of anesthesia scenario simulation training centered on clinical engineers combined with Miller’s pyramid teaching method in improving the emergency response ability and comprehensive competence of specialized operating room nurses. Methods: A randomized controlled trial was conducted. A total of 100 specialized operating room nurses working in our hospital from October 2023 to October 2025 were enrolled and randomly divided into observation group and control group by random sequence method, with 50 cases in each group. The control group received traditional training consisting of routine theoretical lectures and self-study, while the observation group was given a comprehensive training program integrating clinical engineer-led scenario simulation training and Miller’s pyramid teaching method, with a training cycle of 6 months. The scores of emergency response ability and comprehensive competence before and after training, the duration of operation suspension caused by troubleshooting, teaching satisfaction and professional identity were compared between the two groups. Results: Before training, there were no significant differences in the scores of emergency response ability and comprehensive competence between the two groups (all P > 0.05). After training, the scores of emergency response ability and comprehensive competence in the observation group were (86.6 ± 7.7) points and (168.1 ± 10.2) points respectively, versus (76.9 ± 8.4) points and (145.2±9.6) points in the control group, with statistically significant differences (t = 6.019, 11.560, P = 0.001, 0.001). The operation suspension duration caused by troubleshooting was (5.12 ± 1.63) min in the observation group and (10.15 ± 2.93) min in the control group, showing a significant difference (t = 6.709, P = 0.001). The teaching satisfaction rate and professional identity rate were 96.00% (48/50) and 94.00% (47/50) in the observation group, while those in the control group were 82.00% (41/50) and 80.00% (40/50), with statistically significant differences (χ² = 5.005, 4.332, P = 0.025, 0.037). Conclusion: Scenario simulation training combined with Miller’s pyramid teaching method can effectively enhance the emergency response ability and comprehensive competence of specialized operating room nurses, improve their recognition of teaching work and professional identity, and shorten the operation suspension time due to equipment troubleshooting. It is a systematic clinical training mode worthy of clinical promotion.