技能培训结合情景案例提高住院医师急救能力的教学实践

Teaching exploration of practice skills training combined with scenario analysis on improving thefirst-aid ability of emergency residents

目的探讨应用模拟临床实践技能培训结合情景案例分析提高急诊住院医师的急诊急救临床实践能力。方法选取中国医科大学附属盛京医院2016届规范化培训住院医师218人，随机分成2组。其中实验组134人，采用模拟临床实践技能培训结合情景案例分析对住院医师进行培训；对照组84人。采用传统授课结合教学视频演示的方式对住院医师进行培训。比较两组住院医师理论考试成绩和实践技能考核成绩，并对上述两种教学模式进行问卷调查。使用SPSS19．0进行t检验和秩和检验。结果实验组和对照组住院医师理论考试成绩分别为（85．27±5．59）和（84．11±7．43），差异无统计学意义（P〉0．05）；实验组的技能考核成绩（89．42±6．63），明显高于对照组（71.36±4．41），差异有统计学意义（P〈0．05）。实验组住院医师对指导教师和教学方法的非常满意比例分别占70．90％和80．60％．优于对照组的23．81％和33．33％。实验组住院医师对自身学习的非常满意比例达到64．93％，高于对照组的39．29％。结论采用模拟临床实践技能培训结合情景案例分析，能够显著提高急诊住院医师的急诊急救临床实践能力，有望应用于未来的急诊住院医师规范化培训。

Objective To improve the first-aid ability of emergency residents by using simulated clinical practice skills training combined with scenario analysis in standardized residency training. Methods 218 residents who participated in standardized residency training in Shengjing Hospital of China Medical University were randomly distributed to two groups. The experimental group （n=134） was trained with the teaching methods of simulated clinical practice skills training combined with scenario analysis; the control group （n=84） was trained with traditional teaching methods combined with teaching video. The theoretical test scores and clinical practice skills results of the two groups were compared, and a questionnaire survey was also conducted after comparing the two teaching modes. T test and rank-sum test were performed by using SPSS 19.0. Results There was no significant difference in the theoretical test scores between the experimental group （85.27 ± 5.59） and the control group （84.11 ±7.43） （P〉0.05）. However, the clinical practice skills scores of the experimental group （89.42± 6.63） were significantly higher than those of the control group （71.36 ± 4.41） （P〈0,05）, which showed the statistical significance. Student＇s satisfactions with teachers and teaching methods in the experimental group were 70.90% and 80.60%, respectively, which were extremely higher than those in the control group （23.81% and 33.33%）. Student＇s satisfaction with self- learning in the experimental group （64.93%） was significantly higher than that in the control group （39.29%）. Conclusions The application of simulated clinical practice skills training combined with scenario analysis could improve the first-aid ability of emergency residents. This teaching method is expected to be applied in standardized residency training in emergency medicine in the future.