基于ASK模型的四步培训法联合工作坊在医学生院感防控培训中的应用

Application of a ASK model-based four-step training method combined with workshops in training on the prevention and control of nosocomial infection for medical students

目的探讨基于ASK模型[包括态度(attitude,A)、技能(skill,S)、知识(knowledge,K)]的四步培训法联合工作坊在实习生院感防控培训的应用效果,为医学生的院感防控培训模式改革及建立院感防控培训体系提供参考依据。方法选取2018至2020年进院实习的5所医学院校的医学生,分为对照组(2018至2019年208名医学生,进行院感防控常规培训)和试验组(2019至2020年216名医学生,实施基于ASK模型的四步培训法联合工作坊的院感防控培训),比较两组医学生手卫生依从率、院感防控理论及技能考核达标率、医疗废物处置正确率、职业暴露发生情况、教学满意度。运用SPSS 19.0统计软件进行卡方检验和t检验。结果试验组学生各项指标均优于对照组,差异均有统计学意义(均P<0.05)。试验组手卫生依从率(χ^(2)=4.92,P=0.027)、医疗废物处置正确率(χ^(2)=5.13,P=0.023)、院感防控理论达标率(χ^(2)=4.03,P=0.038)及技能达标率(χ^(2)=6.71,P=0.010)、教学满意度均高于对照组[(98.03±2.16)分vs.(92.53±2.01)分]。试验组学生未发生职业暴露,对照组发生3例职业暴露。结论基于ASK模型的四步培训法联合工作坊对实习生院感防控培训模式有效,作为一种创新培训方法,提升了临床带教的满意度,为建立院感防控培训体系提供了依据。

Objective To explore the effects of applying a four-step training method based on an attitude-skill-knowledge(ASK)model combined with workshops in training on the prevention and control of nosocomial infection among medical students,and to provide a reference for reforming nosocomial infection prevention and control training for medical students and establishing a nosocomial infection prevention and control training system.Methods Medical students from five medical schools entering clerkships during 2018 to 2020 were selected.They were divided into control group(218 medical students in 2018-2019 receiving conventional nosocomial infection control training)and experimental group(216 medical students in 2019-2020 receiving nosocomial infection control training based on the ASK model-based four-step method combined with workshops).The two groups were compared in terms of the compliance rate of hand hygiene,the pass rates of nosocomial infection control theory and skill examinations,the correct rate of medical waste disposal,the incidence of occupational exposure,and the degree of satisfaction with teaching.Results All the indices of the experimental group were significantly better than those of the control group:the compliance rate of hand hygiene(χ^(2)=4.92,P=0.027),the correct rate of medical waste disposal(χ^(2)=5.13,P=0.023),the pass rate of nosocomial infection control theory examination(χ^(2)=4.03,P=0.038),the pass rate of nosocomial infection control skill examination(χ^(2)=6.71,P=0.010),and the degree of satisfaction with teaching[(98.03±2.16)vs.(92.53±2.01),P<0.001].No one had occupational exposure in the experimental group,while there were three cases in the control group.Conclusion The ASK model-based four-step method combined with workshops is effective in nosocomial infection prevention and control training for medical students.This innovative training method improves students'satisfaction with clinical teaching,providing a basis for the establishment of a training system for the prevention and control of nosocomial infection.