强化医学模拟教学在全科医师临床技能培训中的应用研究

Enhanced medical simulation teaching in clinical skills training of general practitioners

目的探索强化医学模拟教学在全科医师临床技能培训中的应用效果,以期为相关临床教学提供参考。方法本研究选取2019年9月—2021年1月进入重庆市第九人民医院全科医师规范化培训基地的学员102名为研究对象。采用随机数字表法将学员分为观察组与对照组,每组51例。对照组学员采取传统教学模式,观察组学员采用传统教学与强化医学模拟教学相结合的教学模式。比较2组学员培训前后(培训后为规培结束时)技能操作考核评分;比较2组学员培训满意度。结果培训前,2组学员内科技能、外科技能、儿科技能、妇产科技能、急诊科技能、体格检查评分及总分比较,差异无统计学意义(P>0.05)。培训后,2组学员内科技能、外科技能、儿科技能、妇产科技能、急诊科技能、体格检查评分及总分均高于培训前,且观察组高于对照组,差异均有统计学意义(P<0.05)。观察组学员在对培训老师的满意度、培训增强学员临床自信心、培训提供的操作机会、学员自主利用技能中心的程度、培训课程的趣味性、培训对学员协作能力培养、对培训基地的满意度方面的评分高于对照组,差异均有统计学意义(P<0.05)。观察组学员在培训时师生互动情况、培训内容的系统性及完整性、培训对学员医患沟通及人文关怀能力培养方面的评分与对照组比较,差异无统计学意义(P>0.05)。结论传统教学与强化医学模拟教学相结合的教学模式,有利于提高全科医师规范化培训学员的临床技能操作水平及其对教学的满意度,并能提高培训基地的教学质量。

Objective This paper aims to explore the effect of enhanced medical simulation teaching in clinical skills training of general practitioners to provide evidence for relevant clinical teaching.Methods In this study,102 trainees who entered the standardized training base for general practitioners in the Ninth People's Hospital of Chongqing from September 2019 to Jan-uary 2021 were selected as participants.They were assigned to the observation and control groups by random number table,with 51 cases in each group.The trainees in the control group received traditional teaching,and the trainees in the observa-tion group the teaching model combining traditional teaching with enhanced medical simulation teaching.The skill operation assessment score before and after training(at the end of training)and the degree of satisfaction with the training of the two groups were compared.Results Before training,there was no significant difference in subscale and total scores of medical skills,surgical skills,pediatric skills,obstetrics and gynecology skills,emergency skills,and physical examination between the two groups(P>0.05).After training,the subscale and total scores of medical skills,surgical skills,pediatric skills,obstetrics and gynecology skills,emergency skills,and physical examination of the trainees in the 2 groups were higher than those before training,and the observation group was higher than the control group,with statistical significance(P<0.05).The scores of trainees'satisfaction with training teachers,increase in trainees'clinical self-confidence,operation opportuni-ties provided by training,degree of trainees'independent use of skill centers,interest in training courses,trainees'collabo-rative ability training,and satisfaction with training bases in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in the scores of the interaction between teachers and students,the systematicness and integrity of training content,and the training scores for doctor-patient communication and humanistic concern of trainees between the observation group and the control gvoup(P>0.05).Conclusion The teaching mode com-bining traditional teaching with enhanced medical simulation teaching is beneficial to raising the operation level of clinical skills and degree of satisfaction with the teaching of general practitioner trainees in standardized training and improving the teaching quality of training bases.