医学情景模拟在全科门诊教学中的应用

Application of Medical Scenario Simulation in General Practice Outpatient Education

目的观察医学情景模拟在全科医学门诊带教中的效果。方法2017年10—12月,应用情景模拟对南京市第一医院全科规范化培训34名住院医师进行门诊教学,评分表评价模拟前后的接诊能力,包括临床技能和医患沟通。以得分率、提升率来评价各项接诊技能的掌握程度。结果模拟教学前,门诊接诊能力得分率分别为(63.12±10.16)%,(54.18±12.16)%,以临床资料收集、客观检查、信息收集和反馈能力得分率较高,模拟教学后门诊接诊能力显著提高(83.34±7.12)%,(86.65±13.18)%,差异具有统计学意义(P <0.05),以病情评价、诊疗计划、结束接诊、从患者的角度理解问题、信息共享和知情同意等软技能提升率显著增高。结论医学情景模拟可提高全科住院医师门诊接诊能力,尤其在病情评价、诊疗计划、医患沟通等软技能方面。

Objective To observe the effect of medical scenario simulation in general practice outpatient education. Methods From October to December 2017, 34 residents in Nanjing First Hospital were trained by scenario simulation in outpatient teaching. The scoring table was used to evaluate the reception ability before and after the simulation, including clinical skills and patient communication. The score rate and promotion rate were used to evaluate the mastery degree of various medical skills. Results Before simulated teaching, the scores of outpatient visiting ability were (63.12±10.16)%,(54.18±12.16)%, respectively. The scores of clinical data collection, objective examination, information collection and feedback ability were higher. After simulated teaching, outpatient visiting ability was significantly improved (83.34±7.12)%,(86.65±13.18)%. The difference was statistically significant (P < 0.05). Soft skills such as condition evaluation, diagnosis and treatment plan, end of visits, understanding problems from the perspective of patients, information sharing and informed consentwere significantly increased. Conclusion The medical scenario simulation can improve the outpatient consultation ability of the general physicians especially in the soft skills of condition evaluation, diagnosis and treatment plan, physician-patient communication and so on.