基于综合医院全科医学科慢性病照护门诊的一体化教学模式效果评价

Evaluation of integrated teaching model based on chronic disease care clinic in general practice department of general hospital

选取首都医科大学附属北京同仁医院2018—2020级进行全科住院医师规范化培训(简称"住培")的医生20名为研究组,轮转全科医学科慢性病照护门诊前后分别进行入科及出科理论、技能考核、自我评价,出科时进行360度评估,与同期轮转内科常规门诊的39名住培医生出科360度评估比较,对教学效果综合评价。结果显示研究组出科时的理论、技能考核成绩均较入科时明显提升,差异有统计学意义(P<0.01);出科时能力自我评价较入科时明显提高,尤其在全科思维[(7.85±0.88)分]、医患沟通[(7.95±0.69)分]、健康教育[(7.80±0.70)分]及疾病管理[(8.20±0.62)分]方面更为显著(P<0.01)。出科360度评估显示,在人际和沟通技能[(4.75±0.44)比(4.41±0.50)分]、基于体系的工作能力[(4.75±0.44)比(4.31±0.47)分]、基于实践的学习和提高[(4.80±0.41)比(4.33±0.48)分]、患者照护[(4.75±0.44)比(4.28±0.46)分]以及培训模式满意度[(4.85±0.37)比(4.38±0.49)分]方面研究组均优于对照组,差异有统计学意义(P<0.05)。提示在全科住培教学中,发挥综合医院全科医学科慢性病照护门诊的平台优势,整合多学科的一体化教学模式能提高教学效果,改善教学质量,为全科住培提供了新的思路和模式。

Twenty general practice residents who received training in Tongren Hospital from 2018 to 2020 were enrolled. The residents undertook rotation in chronic disease care clinic of the general medicine department, and a multi-disciplinary integrated teaching mode was applied. The theoretical knowledge test, skill assessment and self-evaluation were performed before and after rotation. The 360-degree evaluation was carried out when leaving the department (study group), the results were compared with that of internal medicine (control group) in the same period. The teaching effect was comprehensively evaluated. The scores of theoretical knowledge and skill assessment after rotation were significantly higher than those before rotation ( P<0.01). The self-evaluated ability was significantly higher than that at admission, especially in general practice thinking (7.85±0.88), doctor-patient communication (7.95±0.69), health education (7.80±0.70) and disease management (8.20±0.62) ( P<0.01). The 360-degree evaluation showed that the study group was better than the control group in interpersonal communication skills [(4.75±0.44) vs. (4.41±0.50)], system-based work ability[(4.75±0.44) vs. (4.31±0.47)], practice-based learning and improvement [(4.80±0.41) vs. (4.33±0.48)], patient care [(4.75±0.44) vs. (4.28±0.46)] and training mode satisfaction [(4.85±0.37) vs. (4.38±0.49)] (all P<0.05). The study indicates that the multi-disciplinary integrated teaching mode applied for rotation in the chronic disease care clinic of the general medicine department can improve the teaching effect and raise the teaching quality for general practice residency training.