基于真实诊疗实践的多元评价体系在抗菌药物合理应用培训中的作用

The value of the multi-evaluation system based on real clinical practice in the training of rational application of antibacterials

目的:探讨基于真实诊疗实践开展的多元评价体系在抗菌药物合理应用培训中的效果。方法:将60名参加住院医师规范化培训的专业学位研究生随机分为观察组和对照组,各30人,分别完成为期2个月的抗菌药物合理应用培训教学。观察组将基于真实诊疗实践的多元化评价体系应用于教学查房和实践,围绕每个病例进行反复即时考核。对照组按照以往的课堂教学式查房进行带教,带教医生对每个疾病进行理论联系实践的课堂式教学,查房结束后不检查学生对相关知识的掌握程度。培训结束后,进行抗菌药物合理应用出科测试评估,比较2组测试得分。结果:观察组在病史采集水平、体格检查能力、医患沟通能力和操作技能规范程度四个方面的考核得分均明显高于对照组(P<0.01)。观察组对感染性疾病的理论知识和诊断能力得分均明显高于对照组(P<0.01),抗菌药物合理应用得分亦明显高于对照组(P<0.01)。结论:基于真实诊疗实践的多元评价体系在抗菌药物合理应用培训中的效果较好,值得进一步推广。

Objective:To explor the value of the multi-evaluation system based on real clinical practice in the training of rational application of antibacterials.Methods:Sixty graduate students who participated in the standardized training for resident physicians were randomly divided into the observation group and control group(30 cases each group),and the training and teaching of rational application of antibiotics of 2 months in two gorups were completed.For the observation group,the diversified evaluation system based on real diagnosis and treatment practice were applied in teaching rounds and practice,and the repeated real-time assessment was conducted around each case.The control group were taught according to the previous classroom teaching style of ward rounds,the classroom teaching of theory and practice for each disease was performed by the teaching doctor,and,the students′mastery of relevant knowledge was not checked after the ward rounds.After the training,the rational application of antibiotics was tested and evaluated,and the test scores between two groups were compared.Results:The test scores of the level of medical history collection,physical examination ability,doctor-patient communication ability and standard degree of operation skills in observation group were significantly higher than those of in control group(P<0.01).The scores of theoretical knowledge and diagnostic ability of infectious diseases in observation group were significantly higher than those in control group(P<0.01),and the scores of rational use of antibiotics in observation group were also significantly higher than those in control group(P<0.01).Conclusions:The multi-evaluation system based on real clinical practice is effective in the training of rational application of antibacterials,it is worthy of further promotion.