基于OBE的TPA阶梯教学在神经内科住院医师规范化培训中的应用

Application of OBE-Based TPA Step-By-Step Teaching in the Standard⁃ized Training of Neurology Residents

目的探讨基于以结果为导向教育(outcomes-based education,OBE)的理论实践应用(theory-practic-application,TPA)阶梯式教学在神经内科专业住院医师规范化培训中的应用效果。方法选取2017年9月—2020年9月南京医科大学附属泰州人民医院52名神经内科专业住培医师为研究对象,根据时间分组,将2017年9月—2018年12月入学的24名住培医师归为对照组,采取传统教学模式;将2019年1月—2020年9月入学的28名住培医师归为研究组,采取基于OBE的TPA阶梯式教学,对比两组理论考核、实践能力考核以及满意度情况。结果两组住培医师3年间理论成绩均逐步提高,且每年研究组的理论考核成绩均明显高于对照组,差异有统计学意义(P<0.05)。两组入科时Mini-CEX评分比较,差异无统计学意义(P>0.05);出科时,两组Mini-CEX得分均高于入科时,且研究组Mini-CEX得分和360度评估得分均高于对照组,差异有统计学意义(P<0.05)。研究组总满意率明显高于对照组,差异有统计学意义(P<0.05)。结论在神经内科专业住院医师规范化培训中采用基于OBE的TPA阶梯式教学模式带教,可提高神经内科专业住培医师理论、技能成绩及其临床综合素养,并可提高教学的满意度。

Objective To explore the application effect of the theory practice application(TPA)ladder teaching based on outcome-based education(OBE)in the standardized training of Neurology professional residents.Methods 52 resi-dent physicians in Neurology of Taizhou People's Hospital Affiliated to Nanjing Medical University from September 2017 to September 2020 were selected as the research objects.According to the time grouping,24 resident physicians enrolled from September 2017 to December 2018 were classified into the control group,and the traditional teaching mode was adopted;28 resident training physicians enrolled from January 2019 to September 2020 were assigned to the research group,and a TPA tiered teaching approach based on OBE was adopted.The theoretical assessment,prac-tical ability assessment,and satisfaction level between the two groups were compared.Results The theoretical perfor-mance of the two groups of resident training physicians has gradually improved over the past three years,and the theo-retical assessment scores of the research group are significantly higher than those of the control group each year,the difference was statistically significant(P<0.05).There was no statistically significant difference in Mini-CEX scores between the two groups at admission(P>0.05).At the time of graduation,the Mini-CEX scores of both groups were higher than those at the time of enrollment,and the Mini-CEX scores and 360 degree evaluation scores of the study group were higher than those of the control group,the difference was statistically significant(P<0.05).The total satis-faction rate of the research group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion Adopting the OBE-based TPA step-by-step teaching model in the standardized training of neurology resident physicians can improve the theory,skill performance and clinical comprehensive quality of neurology resident physicians,and improve teaching satisfaction.