多学科诊疗联合ARCS动机模式教学在肿瘤内科住院医师规范化培训中的应用

Application of multidisciplinary diagnosis and treatment combined with ARCS model in standardized training for oncology residents

目的探讨多学科诊疗(multi-disciplinary treatment,MDT)联合ARCS动机模式教学方法在临床肿瘤内科住院医师规范化培训中的应用效果。方法选取2020年1月1日至2021年12月31日在空军军医大学第一附属医院肿瘤科接受住院医师规范化培训的30名学员进行肿瘤内科临床教学,按随机数字表法分为观察组和对照组,每组15例;对照组采用带教老师指导下参与MDT的教学方法,观察组采用MDT联合ARCS动机模式的教学方法。教学前使用调查问卷对两组学员的临床肿瘤学相关理论知识初始掌握程度及学习意愿进行调查分析。教学结束后,对两组学员进行临床肿瘤学理论知识和临床技能考核,使用调查问卷的形式调查两组学员对教学的满意程度、自信心、角色意识及对肿瘤专业的学习兴趣。结果教学前,观察组与对照组对临床肿瘤学相关理论知识的初始掌握程度差异无显著性(t=0.650,P=0.521)。观察组和对照组学员认为肿瘤专业知识对个人临床工作具有帮助的比例分别为100%(15/15)、86.6%(13/15),差异无显著性(χ^(2)=3.686,P=0.298)。教学后,两组学员理论知识得分差异无显著性,观察组文献阅读、临床技能以及考核总分均高于对照组,差异有显著性(P<0.05)。观察组记忆性知识点正确率与对照组比较差异无显著性(t=1.120,P=0.335),应用性知识点正确率高于对照组,差异有显著性(t=2.378,P=0.025)。两组学员对肿瘤内科住培的满意程度评分均较高,在临床能力自我认知的三个问题中,观察组评分均高于对照组,差异有显著性(P<0.05)。教学后,观察组对肿瘤专业的学习兴趣评分明显高于教学前及对照组,差异有显著性(P<0.05)。结论多学科诊疗联合ARCS动机模式教学可有效增强学员对肿瘤学临床教学要点尤其是实践能力的掌握,同时提高了学习主动性和教学满意度,增强了职业信心。

Objective To explore the application of multidisciplinary diagnosis and treatment(MDT)combined with ARCS model in the standardized training of medical oncology residents.Method 30 physicians who received standardized resident training in the First Affiliated Hospital of Air Force Medical University from January 1,2020 to December 31,2021 were selected and randomly divided into observation group and control group,15 cases in each group.The control group was taught with MDT model.The observation adopted MDT combined with ARCS model.After the training,theoretical knowledge and clinical skills were assessed,and the differences in teaching satisfaction,initiative,and self-confidence between the two groups were analyzed by questionnaires.Result Before teaching,there was no significant difference between the initial mastery of knowledge related to clinical oncology between the observation group and the control group(t=0.650,P=0.521).The observation and control participants rated 100%(15/15)and 86.6%(13/15)of oncology expertise as helpful,with no significance(χ^(2)=3.686,P=0.298).After teaching,the theoretical knowledge scores of the two groups were not significant,and the total scores of literature reading,clinical skills and assessment in the observation group were higher than that of the control group,and the difference was significant(P<0.05).The difference between the accuracy of memory knowledge points of the observation group and the control group(t=1.120,P=0.335),the accuracy of applied knowledge points was higher than that of the control group,and the difference was significant(t=2.378,P=0.025).Both groups had higher scores on the satisfaction degree of the medical oncology medical residential training.Among the three questions of self-cognitive ability,the observation group scored higher scores than the control group,and the difference was significant(P<0.05).After teaching,the observation group’s oncology specialty learning interest score score was,which was significantly higher compared with the control group and the observation group before teaching(P<0.05).Conclusion MDT combined with ARCS model can effectively enhance students’mastery of clinical oncology teaching points,especially practical ability,improve learning initiative and teaching satisfaction,and enhance career confidence.This model can enrich the choice of teaching methods for standardized training of medical oncology residents.