案例式教学联合多学科诊疗教学在住院医师规范化培训乳腺外科实施的效果研究

Effect of case-based learning combined with multi-disciplinary treatment in standardized residency training in breast surgery

目的研究案例教学法(case-based learning,CBL)联合多学科诊疗(multi-disciplinary treatment,MDT)模式的教学方式应用于乳腺外科住院医师规范化培训中的效果。方法选取2015年7月—2020年7月在柳州市人民医院乳腺外科进行培训的住院医师86人为研究对象,随机分成观察组、对照组,每组各43人,观察组采取CBL联合MDT教学方式,对照组采取传统教学方式。采用客观成绩测定及培训对象主观评价教学满意度来评估不同教学方式的教学效果。结果观察组的基础理论知识成绩、临床病例分析成绩和标准化病人问诊查体成绩均高于对照组[基础理论知识成绩(90.86±4.50)分比(83.75±4.05)分,P<0.01;临床病例分析成绩(89.82±5.94)分比(83.57±7.58)分,P<0.01;标准化病人问诊查体成绩(91.66±3.92)分比(87.38±4.46)分,P<0.01],基本技能操作成绩与对照组相比差异无统计学意义[基本技能操作成绩(88.24±5.50)分比(87.06±4.85)分,P>0.05];观察组的教学满意度调查高于对照组(P<0.05)。结论CBL与MDT相联合的教学方式具有整合性强、理论紧密结合实践及有效培养临床思维等优势,能够有效提高乳腺外科住院医师规范化培训的教学效果。

Objective To study the effect of case-based learning combined with multi-disciplinary treatment teaching mode in standardized training of breast surgery residents.Methods 86 residents who received standardized resident training in breast surgery department of Liuzhou People's Hospital from July 2015 to July 2020 were randomly divided into observation group and control group,each group of 43 people.Observation group used CBL and MDT teaching method and control group used traditional teaching method.The teaching effects of different teaching methods were evaluated by objective performance measurement and students'subjective evaluation of teaching satisfaction.Results The basic theory scores and case analysis of observation group were higher than those of control group[basic theory scores(90.86±4.50)points vs(83.75±4.05)points,P<0.01;case analysis scores(89.82±5.94)points vs(83.57±7.58)points,P<0.01;standardized patient physical examination scores(91.66±3.92)points vs(87.38±4.46)points,P<0.01]and comparing with the control group there was no significant difference in clinical practice[clinical practice scores(88.24±5.50)points vs(87.06±4.85)points,P>0.05];the teaching satisfaction survey showed that the scores of observation group were higher than control group,with statistical significance(P<0.05).Conclusion CBL combined with MDT has the advantages of strong integration,close combination of theory with practice and effective cultivation of clinical thinking,and can improve the teaching effect of the standardized training for breast surgeon residents as well.