以目标为导向的分级责任制在急诊科规培带教中的实践研究

Practical research on goal-oriented hierarchical responsibility system in emergency standardized training and teaching

目的探讨以目标为导向的分级责任制在急诊科规培带教中的实践效果。方法选取2019年3月至2019年8月在复旦大学附属华山医院急诊科轮转的43名规培医师作为对照组,实施传统带教;选取2019年9月至2020年3月轮转的41名规培医师作为研究组,实施以目标为导向的分级责任制带教。均带教3个月。比较两组带教前后理论和临床技能考核成绩、临床综合能力及教学认可度。采用SPSS 24.0进行t检验和卡方检验。结果带教后两组理论知识题、问答题、病例分析题得分均高于带教前(P<0.05),且研究组以上得分高于对照组(P<0.05);带教后研究组对技能适应证、解剖和操作的了解,操作前准备,无菌操作,操作能力,操作后处理,沟通能力,人文关怀,整体表现8项得分均高于对照组(P<0.05);研究组对教学管理、教学方法、教学内容及教学效果的认可度均高于对照组(P<0.05)。结论在急诊科规培医师带教中应用以目标为导向的分级责任制,有助于提高其理论和临床技能考核成绩及临床能力,教学认可度高。

Objective To explore the practical effect of goal-oriented hierarchical responsibility system in the teaching of emergency standardized training.Methods A total of 43 residents who rotated in the Emergency Department of Huashan Hospital Affiliated to Fudan University from March 2019 to August 2019 were selected as the control group,and traditional teaching was implemented.Another 41 residents who rotated from September 2019 to March 2020 were selected as the research group,and the goal-oriented hierarchical responsibility system of teaching was implemented.They were all taught for 3 months,and the scores of theoretical and clinical skills,clinical comprehensive ability and teaching recognition before and after teaching were compared between the two groups.SPSS 24.0 was used for t-test and Chi-square test.Results After teaching,the scores of theoretical knowledge questions,question and answer questions and case analysis in the two groups were higher than those before teaching(P<0.05),and the scores of the research group were higher than those in the control group(P<0.05).After teaching,the scores of 8 items in the study group on understanding of skill indications,anatomy and operation,preparation before operation,aseptic operation,operation ability,post-operation treatment,communication ability,humanistic care and overall performance were higher than those in the control group(P<0.05).The recognition rates of teaching management,teaching methods,teaching content and teaching effect in the research group were higher than those in the control group(P<0.05).Conclusion The application of goal-oriented hierarchical responsibility system in the teaching of standardized training of emergency residents is helpful to improve their theoretical and clinical skill examination results and clinical ability,with high degree of teaching recognition.