实践整合在住院医师规范化培训技能教学中的应用

Application of the practicing integrated teaching in standardized resident training of clinical skill

目的探讨实践整合教学方法应用于住院医师规范化培训医师(以下简称住培医师)的技能教学效果。方法选择2018—2019年本院招录的本科学历住培医师共73名作为研究对象,其中2018年招录的28名为对照组,采用传统教学方法;2019年招录的35名为实验组,采用实践整合的教学方法。两组均在轮转的第一年培训28项基本技能,培训结束后分析两组学员对教学方法的满意程度、兴趣程度、对教师的总体评价、平均每项技能自学投入时间、查阅文献次数;应用DXR-Clinician软件进行临床思维考核;并进行技能相关理论的试卷考核。结果实验组住培医师对教学的满意程度、兴趣程度、平均每项业余学习时长、查阅文献平均次数均优于对照组,差异具有统计学意义(均P<0.05),对教师的满意程度无统计学差异(P>0.05)。DXR-Clinician临床思维测验结果,实验组有三项均高于对照组,差异有统计学意义[临床思维(P=0.014)、处置得分(P=0.035)、总分(P=0.048)],诊断得分无统计学意义(P>0.05)。技能相关理论考核,实验组平均成绩(81.26±6.72)高于对照组(77.57±6.41),结果具有统计学差异(P<0.05)。结论实践整合教学方法能有效提升住培医师的临床能力和自学能力。

Objective To explore the effect of the practicing integrated teaching in training of clinical basic skill for physician receiving standardized resident training.Methods A total of 75 standardized training residents,those were recruited in our hospital during 2018 and 2019,were enrolled as study subjects.The 28 residents enrolled in 2018 were divided into control group and gave traditional teaching,and the 35 residents enrolled in the experimental group and gave the practicing integrated teaching.Totally 28 basic skills were trained for all the residents during their first year of rotate.After the training,questionnaire survey was conducted to analyze their satisfaction and interest in the training method,evaluation of teachers,average self-study time of each skill,times of consulting books and literature of the two groups.DXR clinician was used to assess clinical thinking.Paper test on skills related theory was conducted.Results Compared with the control group,the standardized training residents in experimental group performed better in teaching satisfaction,interest,average length of each part-time learning and times of consulting literature or books(all P<0.05),but there was no significant difference in satisfaction on teachers between the two groups(P>0.05).The results of DXR clinical test showed that the scores of clinical thinking(P=0.014),disposal(P=0.035)and total score(P=0.048)of the experimental group were higher than those of the control group,except for the diagnostic score(P>0.05).The average score of skills related theory score in the experimental group was(81.26±6.72),which was higher than that of the control group(77.57±6.41),the difference was statistically significant(P<0.05).Conclusions The application of practice integrated teaching method could effectively improve their clinical ability and self-learning ability of standardized training residents.