临床路径问题导向教学法在心内科住院医师规范化培训中的应用

Application of teaching method of clinical pathway problem guidance in standardized training of cardiological residents

目的探讨基于临床路径的问题导向教学法在住院医师规范化培训中的教学效果研究。方法选取2016年3月-2018年3月在昆明理工大学附属攀钢集团总医院心内科参加住院医师规范化培训学员72名,根据随机化原则被分为试验组38名(接受基于临床路径的问题导向教学)和对照组34名(接受传统的住院医师规范化培训临床教学),两组学员在心内科培训时间2个月,培训结束后通过分析客观和主观考核情况来评价教学效果。结果试验组学员在基础理论知识[(46.3±3.1)分比(41.7±2.9)分]、病例分析[(47.7±2.1)分比(40.2±3.4)分]和技能操作[(46.8±2.7)分比(39.6±4.9)分]评分均高于对照组学员,差异均有统计学意义(P <0.05);试验组学员在激发学习兴趣(81.6%比8.8%)、提高独立思考能力(92.1%比2.9%)、提高学习能力(89.5%比5.9%)、提高病例分析能力(84.2%比8.8%)和提高临床操作技能(81.6%比8.8%)的认同感均高于对照组学员,差异均有统计学意义(P <0.01)。结论基于临床路径的问题导向教学法可有效提高心内科住院医师规范化培训的教学质量。

Objective To explore the teaching effect of clinical pathway problem guidance in standardized training of cardiological residents. Methods From March 2016 to March 2018, we enrolled 72 residents in Department of Cardiology of the Pangang General Hospital of Kunming University of Science and Technology. According to the randomization principle, they were divided into experimental group （38 trainees accept the clinical pathway problem guidance method） and control group （34 trainees accept the clinical teaching of traditional standardized training of residents）. The trainees were trained in the Department of Cardiology for 2 months. After training, we evaluated the teaching effect by analyzing objective and subjective assessments. Results The basic theoretical knowledge in the experimental group was higher than that in the control group [（46.3±3.1） vs. （41.7±2.9）]. The case analysis in the experimental group （47.7±2.1） was higher than that in the control group （40.2±3.4）. The skill operations in the experimental group （46.8±2.7） was higher than that in the control group （39.6±4.9）. The difference of the two groups was statistically signifcant （P〈0.05）. In terms of arousing learning interest, improving the independent thinking, learning ability, case analysis ability and clinical skill operations, the experimental group were higher than the control group respectively （81.6%vs.8.8%）, （92.1%vs.2.9%）, （89.5%vs.5.9%）, （84.2% vs.8.8%）, （81.6% vs.8.8%）. The difference of the two groups was statistically signifcant （P〈0.05）. Conclusion The clinical pathway problem guidance method can effectively improve teaching quality of standardized training of cardiological residents.