在模拟教学中强化口腔全科住院医师自我评估能力培训的初步研究

Teaching general dental resident self-Assessment through faculty feedback in simulation teaching: a preliminary analysis

目的:评价在模拟教学中强化口腔全科住院医师自我评估能力培训的效果。方法:将北京协和医院口腔全科基地在陪的31名住院医师,按年级分成三组,在进行针对上颌第一磨牙开髓术、上颌中切牙烤瓷全冠牙体预备、龈下刮治术、口内切开缝合四个项目的为期8周的集中模拟教学中对三组住院医师进行不同强度的自我评估能力的培训。通过比较OSECs模拟考试的成绩、自我评估的准确性及与教师评估的一致性,评价教学效果。结果:加强自我评估能力组的住院医师的各专业模拟考试成绩均较其他两组高,其差异具有统计学意义(P<0.05)。且该组住院医师的自我评估与教师评估的一致性较高,具有统计学意义:右上颌第一磨牙开髓术Kappa值为0.413(P<0.05);中切牙烤瓷全冠预备Kappa值为0.564(P<0.05);龈下刮治的k appa值为0.428(P<0.05);口内切开缝合的Kappa值为0.584(P<0.05)。自我评估能力培训的强度与师、生评估一致性的提高的Spear man相关性分析显示:中切牙烤瓷全冠预备和口内切开缝合具有统计学显著性意义(Spear manρ系数分别为0.864和0.542,P<0.05)。结论:在模拟教学中加强自我评估能力的培训及个体化的反馈,有益于口腔全科住院医师规范化培训中临床技能培训的教学效果,在自我评价的标准与方法上仍需要进一步的客观化和可量化。

Objective: To evaluate the effect of teaching general dental resident self-Aassessment through faculty feedback in simulation teaching. Methods: 31 residents were divided into three self-assessments training groups according to grade for 4 tasks in simulation teaching platform: access cavity preparation of the first maxillary molar, porcelain fused to metal crown preparation of the middle incisor, subgingival scaling and intra-oral incision and suture. 8 weeks later, the outcomes of practical tests, the accuracy of self-assessment and the consistency to the assessment by instructors. Results: The scores of high intensity training group were higher than the other two groups, exhibited significant differences (P<0.05). The results showed statistically significant moderate agreement between self-assessment and faculty assessment of evaluation for access cavity preparation of the first maxillary molar (Kappa=0.413, P=0.001);porcelain fused to metal crown preparation of the middle incisor(Kappa=0.564, P=0.001), subgingival scaling(kappa=0.428, P=0.001) and intra-oral incision and suture(Kappa=0.584, P=0.001) More intensive training yielded significantly increased agreement only for preparation of porcelain fused to metal crown preparation (Spearman rho=0.864, P=0.012) and intra-oral incision and suture (Spearman rho=0.542, P=0.025). Conclusions: Teaching general dental resident self-assessment through faculty feedback in simulation teaching were an effective way to improve the outcomes of the students’ practical training. Further objectification and quantification are still needed in the criteria and methods of self-assessment.