Debriefing在住院医师心脏骤停团队救治课程中的应用评价

Evaluation on the application of Debriefing in the course of team rescue for residents with cardiac arrest

目的探讨Debriefing在住院医师心脏骤停团队救治课程中的应用评价。方法选择南京医科大学附属泰州人民医院住院医师规范化培训第三阶段2019级132名学员作为研究对象,按照随机数字表法分为观察组及对照组,均66例,观察组采用Debriefing方法进行心脏骤停团队救治课程培训,对照组采用传统培训方法,观察两组培训前后理论及技能成绩、理论知识及临床技能掌握情况、自我测评,同时采用调查问卷进行临床教学效果评价及教学满意度评估。结果培训前,两组住院医师理论成绩、CPR技能、团队合作、情况评估、应急能力、沟通能力及技能总分比较差异无统计学意义(P>0.05),培训后,与对照组相比,观察组住院医师上述分数均升高,组间比较差异有统计学意义[(84.30±13.92)分比(79.55±14.40)分、(19.58±1.23)分比(17.40±1.30)分、(18.66±0.97)分比(16.80±1.22)分、(18.10±1.16)分比(16.38±1.54)分、(19.92±1.28)分比(17.05±1.25)分、(20.25±1.42)分比(17.40±1.46)分、(85.50±4.37)分比(80.25±4.40)分,均P<0.05];培训前,两组住院医师理论知识掌握情况及临床技能掌握情况比较差异无统计学意义(P>0.05),培训后,与对照组相比,观察组住院医师理论知识掌握情况及临床技能掌握情况均提高,组间比较差异有统计学意义(P<0.05);与对照组相比,观察组住院医师培训有效、可提高教学参与度、提高学习主动性、增强团队协作能力、提高综合抢救能力、教学环境及设施满意及希望下次继续开展占比升高,组间比较差异有统计学意义(P<0.05);培训前,两组住院医师自我测评指标中团队合作水平、分析问题的能力、决策能力、掌握知识能力、沟通能力及激发学习兴趣比较差异无统计学意义(P>0.05),培训后,与对照组相比,观察组住院医师上述情况均升高,组间比较差异有统计学意义(P<0.001);观察组教学满意度高于对照组(92.42%比74.24%,P<0.05)。结论Debriefing方法下进行心脏骤停团队救治课程培训可显著提高住院医师临床理论知识,增强临床操作技能,提高教学满意度进而提升临床教学的质量与水平。

Objective To explore the application and evaluation of Debriefing in the course of team rescue for residents with cardiac arrest.Methods 132 students of 2019 grade in the third phase of standardized training for residents in the Taizhou People's Hospital Affiliated to Nanjing Medical University were selected as the research objects.They were randomly divided into the observation group and the control group,with 66 cases in each group.The observation group used Debriefing method to train the team rescue course for cardiac arrest,and the control group used traditional training methods to observe the theoretical and technical achievements,theoretical knowledge and clinical skills mastery,and self-evaluation before and after the training,At the same time,questionnaire was used to evaluate the clinical teaching effect and teaching satisfaction.Results Before the training,the theoretical scores,CPR skills,teamwork,situation evaluation,emergency ability,communication ability and total scores of skills of residents in the two groups were insignificant(P>0.05).After the training,compared with the control group,the above scores of residents in the observation group were higher,and the difference between the groups was statistically significant[(84.30±13.92)vs.(79.55±14.40),(19.58±1.23)vs.(17.40±1.30),(18.66±0.97)vs.(16.80±1.22),(18.10±1.16)vs.(16.38±1.54),(19.92±1.28)vs.(17.05±1.25),(20.25±1.42)vs.(17.40±1.46),(85.50±4.37)vs.(80.25±4.40),P<0.05];before the training,the mastery of theoretical knowledge and clinical skills of residents in the two groups was insignificant(P>0.05).After the training,compared with the control group,the mastery of theoretical knowledge and clinical skills of residents in the observation group were improved,with a statistically significant difference between the groups(P<0.05);Compared with the control group,the resident training in the observation group was effective,which could improve teaching participation,learning initiative,team cooperation ability,comprehensive rescue ability,teaching environment and facilities satisfaction,and hope to continue to carry out next time,with a statistically significant difference between the groups(P<0.05);Before the training,the team cooperation level,ability to analyze problems,decision-making ability,ability to master knowledge,communication ability and stimulate learning interest in the self-evaluation indicators of residents in the two groups were insignificant(P>0.05).After the training,compared with the control group,the residents in the observation group had higher levels of the above conditions,and the difference between the groups was statistically significant(P<0.001);The teaching satisfaction of the observation group was higher than that of the control group(92.42%vs.74.24%,P<0.05).Conclusion Debriefing based training of team rescue course for cardiac arrest can significantly improve the clinical theoretical knowledge of residents,enhance clinical operation skills,improve teaching satisfaction and improve the quality and level of clinical teaching.