基于标准切面培训的教学法在住院医师产前超声病例诊断中的应用

Application of teaching method based on standard section training in prenatal ultrasound diagnosis training among residents

目的探讨基于标准切面培训的教学法在住院医师产前超声病例诊断中的应用价值。方法选取在北京协和医院超声医学科参加住院医师规范化培训的住院医师21人,采用问卷星制作产科超声病例考题并进行测评。问卷1和问卷2分别包含4个胼胝体发育不良(ACC)病例和4个先天性膈疝(CDH)病例的标志性结构识别题目和病例诊断题目。经过标准切面培训后,再次完成病例测评,统计答题正解率。应用χ^(2)检验比较培训前后答题正确率的差异,应用独立样本t检验比较2种病例的答题正确率增长百分比的差异。结果21名住院医师完成问卷1和问卷2的标志性结构识别题目14个,共答题294人次,正确率为61.2%(180/294),完成病例诊断题目8个,共答题168人次,正确率为38.7%(65/168)。培训后标志性结构识别、病例诊断题目的正确率分别上升为80.3%(236/294)、66.7%(112/168)和89.5%(94/105)、67.9%(57/84),与培训前相比差异具有统计学意义(χ^(2)=122.585、27.262和69.048、12.429,P<0.001、<0.001、<0.001、=0.006)。培训后,ACC病例的答题正确率提升36.5%±11.4%,CDH病例的答题正确率平均提升18.3%±13.3%,2种疾病答题正确率提升百分比相比,差异具有统计学意义(t=-3.332,P=0.003)。结论基于标准切面培训的教学法可提升住院医师产前超声病例诊断质量,并且对于单一部位结构畸形病例诊断的培训效果更好。

Objective To assess the application value of standard section training-based teaching method in prenatal ultrasound diagnosis training among residents.Methods Twenty-one residents who participated in standardized training at the Department of Ultrasound of Peking Union Medical College Hospital were selected,and the"Questionnaire Star",an application for making online questionnaires,was used to make the examination questions of obstetric cases for ultrasound evaluation.Questionnaires 1 and 2 contained four cases of agenesis of corpus callosum(ACC)and four cases of congenital diaphragmatic hernia(CDH),respectively.After standard section training,the case evaluation was completed again.The chi-square test was used to compare the correct answer rate between groups,and the independent sample t test was used to compare the percentage increase in the correct answer rate between groups.Results Twenty-one residents completed 14 structure identification questions in questionnaires 1 and 2,and a total of 294 questions were answered,with an correct rate of 61.2%;8 case diagnosis questions were completed,and a total of 168 questions were answered,with an correct rate of 38.7%.After training,the correct rate of structure identification and case diagnosis questions of ACC and CDH rose to 80.3%(236/294)and 66.7%(112/168),and 89.5%(94/105)and 67.9%(57/84),respectively,which were significantly higher than those before training(χ^(2)=122.585 and 27.262,69.048 and 12.429 respectively;P<0.001,<0.001,<0.001,=0.006).After standard section training,the correct answer rate for ACC cases increased by 36.5%±11.4%,and that for CDH cases increased by 18.3%±13.3%;the difference between the two groups was statistically significant(t=-3.332 and P=0.003,respectively).Conclusion Teaching method based on standard section training can improve the prenatal ultrasound diagnosis quality by residents,and provide better training results for single-site structural abnormalities.