循证医学案例研究法在住院医师规范化培训中的应用

Application of evidence-based case study in standardized training of residents

目的探讨循证医学案例研究法在乳腺科临床住院医师规范化培训中的应用效果。方法选取广州中医药大学第二临床医学院2021年4月至12月在乳腺科实习的规培生共24名,根据入科时间限定的教学模式分为2组。对照组11名(男生4名,女生7名),采用传统教学法;试验组13名(男生6名,女生7名),采用循证医学案例研究教学法。轮训结束后通过调查问卷评分和出科考试成绩评价两组教学效果。计量资料符合正态分布,组间比较采用独立样本t检验,计数资料采用χ^(2)检验。结果两组住培医生出科考试成绩、主观题成绩、客观题成绩差异均无统计学意义(均P>0.05);调查问卷评分中,试验组对案例研究循证教学模式的评价显著高于对照组学生对传统教学法的评价,分别是学习兴趣[(6.08±2.02)分比(4.00±1.55)分]、临床思维能力[(6.62±1.66)分比(4.00±1.34)分]、信息获取能力[(7.00±1.35)分比(5.00±1.48)分]、接诊自信心[(6.23±1.92)分比(3.45±1.37)分]、提问能力[(6.23±1.92)分比(4.00±1.90)分],差异均有统计学意义(均P<0.05)。结论在乳腺科住培医师临床轮训阶段开展案例研究为主的循证医学教学模式能提高学生自主学习的能力及对新问题的解决能力。

Objective To explore the application effect of evidence-based case study in the standardized training of clinical residents in a department of mammary gland.Methods A total of 24 regular trainees in Department of Mammary Gland,Second Affiliated Hospital of Guangzhou University of Chinese Medicine from April to December 2021 were divided into a control group and an experimental group according to when they started to worked at this department.The control group had 11 ones,including 4 males and 7 females,and took the traditional teaching method.The experimental group had 13 ones,including 6 males and 7 females,and did the teaching of evidence-based case study.The teaching effects of the two groups were evaluated through the questionnaire survey and graduation examination results.The measurement data of normal distribution were compared between these two groups by independent-sample t test,and the count data by χ^(2) test.Results There were no statistical differences in the scores of graduation examination,subjective questions,and objective questions(all P>0.05).The experimental group had higher praise on the teaching of evidence-based case study than the control group on the traditional teaching;the scores of study interest,clinical thought,achieving information,self-evidence in receiving patients,and questioning in the experimental group were higher than those in the control group[(6.08±2.02)vs.(4.00±1.55),(6.62±1.66)vs.(4.00±1.34),(7.00±1.35)vs.(5.00±1.48),(6.23±1.92)vs.(3.45±1.37),and(6.23±1.92)vs.(4.00±1.90)],with statistical differences(all P<0.05).Conclusion The teaching of evidence-based case study for regular trainees in a department of mammary gland can improve their self-teaching and problem-solving abilities.