专科-老年科联合教学查房在老年病教学中的应用

Application of Combined Specialist with Geriatrics Teaching Wards Round in the Teaching of Geriatrics

目的探讨专科-老年科联合教学查房模式在老年病教学中的应用效果与价值。方法以急性心肌梗死教学查房为例,入选2013年1月-12月在培的住院医师(42人)和研究生(24人)为研究对象,随机分组:试验组33人,由心内科与老年科医师共同主持;对照组33人,由心内科专业医师主持。查房后由教育处人员、学员、患者分别对教学查房质量进行评分,并对学员心肌梗死知识进行再次测评。结果试验组在生活方式问诊、结合老年病特点分析病情、健康管理、注重预防为主理念等方面优于对照组(t值分别为2.008,1.099,2.129,2.309,P值均<0.05);试验组对医患沟通能力、慢性病预防保健知识方面的评价较高(P值均<0.05)。教学查房后两组学员的测试成绩均有明显提高,而试验组在诊断治疗、预防及慢病管理方面的学习效果更加明显(t值分别为8.517,6.400,P值均<0.05)。结论联合查房模式能明显提高老年科医师的教学查房效果,有助于老年科医师临床能力的培养。

Objective To investigate the application effect and result of teaching wards round mode which combined specialist with geriatrics in the teaching of geriatrics.Methods This study was based on the teaching wards round of acute myocardial infarction.66 trainees which included 42 resident doctors and 24 graduate students who received training courses from January to December 2013 were enrolled in the study.Thirty three trainees were randomly assigned to combined specialist/geriatrics model （study group） conducted by one cardiologist and one geriatrician,while the other 33 trainees were assigned to the specialist teaching model （control group） conducted by one cardiologist.Then conducted a score assessment on the teaching effect by workers of education department,trainees and patients,and also made examination on the myocardial infarction knowledge among two groups again.Results Scores of the teaching rounds in study group were significantly higher than in control group,including inquiry of lifestyle,assessing the illness involved geriatrics factors,guidance of health education and highlighting the importance of prevention （t=2.008,1.099,2.129,2.309 respectively,all P＜0.05）.The practitioners in study group were more satisfied with doctor-patient communication,health-care and prevention disease （P＜0.05）.The total scores in both groups increased significantly after teaching rounds,but the study group had better scores in diagnosis and treatment,prevention and management of chronic disease （t=8.517,6.400 respectively,all P＜0.05）.Conclusions The combined specialist with geriatrics teaching wards round mode could improve the quality of teaching,which was helpful to the cultivation of the clinical abilities of geriatrics trainees.