病例讨论对术后谵妄评估教学的临床意义

Clinical Significance of Case Discussion in Teaching Evaluation of Postoperative Delirium

目的探讨以病例为基础的新型讨论式教学对术后谵妄(POD)评估教学的临床意义。方法选取我院2019年12月—2020年12月的60名参与术后谵妄评估教学的实习生作为研究对象,将所有实习生分为研究组与对照组,每组30名,对照组实习生在术后谵妄评估教学中应用常规教学方式,研究组实习生应用以病例为基础的新型讨论式教学,对比两组实习生的笔试成绩,相关知识回答正确情况,并对2015年12月—2019年12月共收治的3136例手术治疗患者术后谵妄发生率进行评估,对比两组实习生对患者的谵妄评估结果,最后分析实习生们对于教学方法的满意度。结果研究组实习生的案例分析成绩、基础知识成绩以及总成绩明显高于对照组,差异有统计学意义(P<0.05);研究组与对照组两组实习在教学前关于术后谵妄相关知识与评估题目的问题回到正确人数对比差异无统计学意义(P>0.05),通过教学后两组实习生的回答正确人数明显提升,但是在POD与量表评估、POD与生物标志物、POD与影像学以及POD与脑电等相关知识的问答题中,研究组实习生回答正确人数明显高于对照组,差异有统计学意义(P<0.05);3136例手术患者通过术后主治医师评估后有462例患者符合谵妄评估标准,其中对照组实习生对患者评估正确率为85.93%,研究组实习生对患者的评估正确率为94.81%,研究组明显高于对照组,差异有统计学意义(P<0.05);研究组实习生对教学方法的满意度为93.33%,对照组实习生对教学方法的满意度为73.33%,研究组明显高于对照组,差异有统计学意义(P<0.05)。结论在术后谵妄评估教学中,应用以病例为基础的新型讨论式教学不仅能够提升关于术后谵妄的基础理论知识,还能够让实习生接触相关病例了解到更多术后谵妄评估方法与相关知识,提升了实习生对教学方法的满意度。

Objective To explore the clinical significance of case-based new discussion teaching in the evaluation of postoperative delirium(POD).Methods 60 interns in our hospital from December 2019 to December 2020 who participated in the teaching of postoperative delirium assessment were selected as the research objects,and all interns were divided into the research group and the control group,with 30 in each group.The control group interns applied the conventional teaching method in the teaching of postoperative delirium assessment,while the research group interns applied the new discussion teaching method based on case,and the differences between the two groups were compared.In addition,the incidence of postoperative delirium in 3136 surgical patients from December 2015 to December 2019 was evaluated,and the delirium evaluation results of the two groups of interns were compared.Finally,the satisfaction of interns with teaching methods was analyzed.Results The scores of case analysis,basic knowledge and total scores of the study group were significantly higher than those of the control group(P<0.05);there was no significant difference in the number of correct answers to questions about postoperative delirium related knowledge and assessment questions between the study group and the control group before teaching(P>0.05),and the number of correct answers of the two groups after teaching was significantly increased,but the number of correct answers was not significantly different In the questions and answers of pod and scale evaluation,pod and biomarkers,pod and imaging,and pod and EEG,the number of correct answers of interns in the study group was significantly higher than that in the control group(P<0.05).After the evaluation of 3136 surgical patients by the attending physician,462 patients met the delirium evaluation standard,among which,the correct evaluation rate of the patients by the interns in the control group was 85.93%,and the correct evaluation rate of the interns in the research group was 94.81%,which was significantly higher the study group was 93.33%,and that of the control group was 73.33%,which was significantly higher than that of the control group(P<0.05).Conclusion In the teaching of postoperative delirium assessment,the application of case-based new discussion teaching can not only improve the basic theoretical knowledge of postoperative delirium,but also make interns contact with relevant cases to learn more postoperative delirium assessment methods and related knowledge,improve interns'satisfaction with teaching methods,which is worthy of application and promotion.