情景式教学在老年内科轮转医师人文素质教育中的应用

Application of scenario-based learning in humanistic education of residents during rotation in department of geriatrics

目的探讨情景式教学在老年内科轮转医师人文素质教育中的价值。方法选择2019年3月5日至2020年4月6日在北京大学第一医院老年内科轮转培训的医师作为研究对象。将其分为情景式教学组和传统教学组,接受包括4周人文知识学习和4周人文精神培养的人文素质教育。人文知识学习采用集体授课方式,两组轮转医师共同参加;人文精神培养两组分别采用情景模拟法和传统授课法。情景式教学组通过模拟日常诊疗工作、急危重症处理、心理障碍老年患者诊治及临终关怀4个场景对轮转医师进行培训,而传统教学组采用教师讲授的方式进行培训。8周培训后,通过模拟医患问诊场景对两组医师进行医患沟通能力评分,从而评估情景式教学在人文素质教育中的作用。采用SPSS 22.0软件进行t检验和Mann-WhitneyU检验。结果共56名轮转医师参与培训过程并完成考核。两组轮转医师在性别、年龄、规范化培训时间上的差异无统计学意义;但情景式教学组的医患沟通能力评分优于传统教学组,分别为(115.80±5.46)分和(109.71±5.82)分,差异有统计学意义(P<0.001)。进一步分析表明,两组在评分量表25个项目中有10个项目(项目3、6、8、12、14、15、18、19、22、24)评分差异有统计学意义(P<0.05)。结论情景式教学在老年内科轮转医师人文素质教育中发挥了重要作用,值得推广。

Objective To explore the value of scenario-based learning(SBL)in humanistic education of residents during rotation in department of geriatrics.Methods Residents who were trained in Department of Geriatrics of Peking University First Hospital from March 5,2019 to April 6,2020 were selected as research objects and they were randomly assigned to SBL group and traditional training(TT)group for 4 weeks of humanistic education including humanistic knowledge learning and humanistic spirit cultivation.For humanistic knowledge learning,56 residents were taught together.For humanistic spirit cultivation,SBL training and traditional training were conducted in the two groups respectively.The SBL group trained the residents through the simulation of such 4 scenarios as daily diagnosis and treatment work,emergency and critical care,diagnosis and treatment of elderly patients with mental disorders and hospice care,while TT group adopted traditional lecturing.After 8 weeks of training,the effects of SBL on the humanistic education were evaluated through simulated doctor-patient consultation scenarios.SPSS 22.0 was used for t test and Mann-Whitney U test.Results A total of 56 residents participated in the training and complete the assessment.There were no significant differences in gender,age and duration of standardized training,respectively.However,the SEGUE scores of doctor-patient communication ability in SBL group were significantly superior to those of the TT group[(115.80±5.46)points vs.(109.71±5.82),P<0.001].Further analysis showed that among the 25 items of SEGUE scale,there were significant difference in the scores of 10 items(3rd,6th,8th,12th,14th,15th,18th,19th,22nd,24th)between the two groups(P<0.05).Conclusion In humanistic education,SBL plays an important role in improving humanistic qualities of rotation residents in department of geriatrics,which is deserved to promote.