模拟临床思维联合CBL在提升胸外科住培医师岗位胜任力中的应用

Application of Simulated Clinical Thinking Combined With CBL in Enhancing the Competency of Resident Training Physicians in Thoracic Surgery

目的探讨模拟临床思维教学结合基于案例的教学法(case-based learning,CBL)在提升胸外科住培医师岗位胜任力中的科学性和可行性。方法选取2019年9月—2020年8月徐州医科大学附属医院胸外科专业学位硕士研究生入科参加住院医师规范化培训(以下简称住培)的医师40名,随机分为试验组和对照组两组(每组20名)。试验组采用模拟临床思维联合CBL教学,对照组采用传统授课教学。比较两组理论知识、实践技能、病案分析考核成绩,岗位胜任力评分和问卷调查形式。结果两组住培医师理论知识考核成绩差异无统计学意义(P>0.05);试验组住培医师实践技能、病案分析考核成绩均高于对照组,差异有统计学意义(P<0.05)。试验组岗位胜任力中人文修养、创新、实践和医患沟通等能力评分均高于对照组,差异有统计学意义(P<0.05),两组解决问题评分差异无统计学意义(P>0.05)。试验组住培医师学习兴趣、自学能力、临床思维、团队协作、教学方式满意度评分均高于对照组,差异有统计学意义(P<0.05)。结论模拟临床思维教学结合CBL教学模式优于传统教学模式,可以提高胸外科住培医师岗位胜任力。

Objective To explore the scientificalness and feasibility of simulated clinical thinking teaching combined with case-based learning(CBL)teaching method in improving the post competency of standard-trained residents in thoracic surgery.Methods A total of 40 physicians with master's degree in thoracic surgery from the Affiliated Hospital of Xuzhou Medical University from September 2019 to August 2020 were selected to participate in the standardized resident training(hereinafter referred to as residential training),and were randomly divided into two groups(20 physicians in each group):experimental group and control group.The experimental group was taught with simulated clinical thinking combined with CBL,while the control group was taught with traditional teaching.The two groups were compared in terms of theoretical knowledge,practical skills,assessment results of medical record analysis,post competency scores and questionnaire forms.Results There was no significant difference between the two groups(P<0.05);the practical skills and medical record analysis scores of the experimental group were higher than those of the control group,and the differences were statistically significant(P<0.05).The scores of humanistic cultivation,innovation,practice and doctor-patient communication in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05),while there was no statistically significant difference in problem-solving scores between the two groups(P>0.05).The scores of learning interest,self-learning ability,clinical thinking,teamwork and teaching method satisfaction of the experimental group were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion The combination of simulated clinical thinking teaching and CBL teaching method is superior to the traditional teaching mode,which can improve the post competence of thoracic surgery resident training physicians.