多学科协作教学在全科医师规培学员临床教学中的应用

The application of multidisciplinary cooperative teaching in the clinical teaching of general practitioners

目的全科带教缺乏全科思维及学科之间的衔接,是目前全科教学中存在的主要问题。因此,本研究探讨多学科协作(multi-disciplinary team,MDT)教学模式在全科医师规培学员临床教学中的实际效果。方法选择2017年在郑州人民医院进行培训的52例全科规培学员为研究对象,采用抽签法将其随机分为实验组和对照组,每组26例。对照组学员在临床教学中采用常规教学方法,即以问题为基础学习教学方法(problem-based learning,PBL),实验组采用多学科协作的PBL教学方法,教学时间为2个月。采用出科考试(包括理论考核、技能考核)和问卷调查形式比较2组学员的教学效果。结果实验组学员理论考试成绩和临床技能考试成绩分别为(92.7±2.5)分和(91.4±3.3)分,对照组学员理论考试成绩和临床技能考核成绩分别为(80.3±5.3)分和(81.2±5.2)分,2组学生成绩差异均有统计学意义(均P<0.05)。实验组学生对以MDT为导向的PBL教学方法的评价优于对照组学生对单一PBL教学方法的评价,2组差异有统计学意义(均P<0.05)。360°间接评价中,患者及医护人员对实验组学员的满意度优于对照组,差异有统计学意义(均P<0.05),学员之间的评价,2组间差异无统计学意义(P>0.05)。主动提出问题总个数方面,实验组优于对照组,差异有统计学意义(P<0.05)。结论多学科协作的PBL教学方法能够提高全科学员的学习成绩,有利于学员全科思维能力和综合素质的培养。

Objective The main problem in general practice teaching is the lack of general practice thinking and the connection between subjects. Therefore, this study is designed to explore the practical effect of multidisciplinary disciplinary collaboration(MDT) teaching model in the clinical teaching of training trainees of general practitioner. Methods A total of 52 general practice trainees from our hospital in 2017 were selected as the research objects and randomly divided into experimental group and control group, with 26 people in each group. The control group adopted conventional teaching method in clinical teaching, i.e., problem-based learning(PBL), and the experimental group adopted the multidisciplinary cooperation PBL teaching method, for a period of 2 months. The results of the two groups were compared by testing on completion of a course including theory examination, skill examination and questionnaires. Results Students in the experimental group scored(92.7±2.5) in theoretical examination and(91.4±3.3) in clinical skills examination, while students in the control group scored(80.3±5.3) in theoretical examination and(81.2±5.2) in clinical skills examination, with statistical significance(all P<0.05). Students in the experimental group following the MDT-oriented PBL teaching method was better than students in the control group following the single PBL teaching method, and the difference between the two groups was statistically significant(all P<0.05). In the 360-ways evaluation, the satisfaction of patients and medical staff to students in the experimental group was better than that in the control group, and the difference was statistically significant(all P<0.05). There was no significant difference between the two student evaluations of each other in groups(P>0.05). The number of people who volunteered questions was higher in the experimental group than in the control group, and the difference was statistically significant(P<0.05). Conclusion Multidisciplinary PBL teaching method can improve the academic performance of general practitioners, and is beneficial to the cultivation of general practitioners’ thinking ability and comprehensive quality.