网络教学在继续医学教育中的应用效果分析

Analysis of the application effect of online teaching in continuing medical education

目的:以非瓣膜性心房纤维颤动继续医学教育为例,对比线上与线下继续医学教育的效果。方法:于2019年10月—2020年6月期间采用单纯随机抽样方法从上海市宝山区、浦东新区、闵行区、嘉定区、静安区、长宁区、崇明区、金山区分别抽取5~6家社区卫生服务中心,选取共43家社区卫生服务中心的935名全科医生作为调查对象。采用单纯随机抽样方法将其中13家社区卫生服务中心的全科医生设为线下组,其他30家的全科医生设为线上组,采取不同的教学方式分别进行非瓣膜性心房纤维颤动继续医学教育,比较两组全科医生培训前后房颤理论知识得分和培训后满意度情况。结果:培训后两组全科医生的房颤理论知识得分差异无统计学意义(P组间=0.537),两组全科医生组内培训前后的房颤理论知识得分差异有统计学意义(P前后<0.001),两组全科医生培训与时间的交互作用差异无统计学意义(P交互=0.354)。两组全科医生在培训知识量接受程度、培训内容难易接受程度和临床思维能力提高程度方面的满意度差异有统计学意义(P<0.05),线上组满意度均高于线下组。结论:建议可开展分层级、分批次、分时段的培训形式,对自学能力较强的学员,可以线上教学为主、线下教学为辅,其他学员则可采用线上、线下混合的教学方式,通过科学组织继续医学教育,促使社区全科医生合理利用时间,有效提升岗位胜任力,为社区居民提供更优质的医疗服务。

Objective:To compare the effect of online and offline continuing medical education taking the continuing medical education of non-valvular atrial fibrillation as an example.Methods:A total of 935 general practitioners in 43 community health service centers were selected as the objects of investigation from 5 to 6 community health service centers in Baoshan District,Pudong New District,Minhang District,Jiading District,Jingan District,Changning District,Chongming District and Jinshan District of Shanghai by simple random sampling method from October 2019 to June 2020.The general practitioners of 13 community health service centers were set as the offline group by simple random sampling,the general practitioners of the other 30 community health service centers were set as the online groups,different teaching methods were adopted for continuing medical education of non-valvular atrial fibrillation and the scores of theoretical knowledge of atrial fibrillation and satisfaction after training were compared between the two groups.Results:After training,there was no statistically significant difference in the theoretical knowledge scores of atrial fibrillation between the two groups of general practitioners(P=0.537).There was a statistically significant difference in the theoretical knowledge scores of atrial fibrillation before and after training between the two groups of general practitioners(P<0.001).There was no statistically significant difference in the interaction between training and time of general practitioners between the two groups(P=0.354).There was a statistically significant difference in satisfaction between the two groups of general practitioners in terms of the degree of acceptance of the amount of training knowledge,acceptance degree of difficult or simple training content and the degree of improvement in clinical thinking ability(P<0.05).Conclusion:It is recommended to carry out training in hierarchical,batch,and time periods,for students with strong self-learning ability,online teaching can be the main and offline teaching as a supplement,other students can use the online and offline mixed way of teaching,and through scientific organization of continuing medical education,the community general practitioners are encouraged to rationally use their time,effectively improve their job competence,and provide community residents with better quality medical services.