PDCA循环在中医全科住院医师临床思维能力培训中的应用

Application of PDCA quality control system in clinical thinking ability training of general practitioners of Traditional Chinese Medicine

目的研究PDCA循环在中医全科住院医师临床思维能力培训中的应用效果。方法选取我院2021年1月至2022年1月在本院全科医学科轮转的中医全科住院医师80名,随机分为观察组和对照组,每组各40名。观察组将PBL及情境模拟教学法与全科门诊相结合,采用PDCA循环对临床思维训练的全过程进行质量控制。传统教学法组采用传统的课堂讲授+实习演练的教学方法。采用出科考核、临床诊断思维病案标准化测试、中医量化临床演练评估考核、教学满意度调查对比两种教学模式的教学效果。结果观察组教学满意度高于对照组,差异具有统计学意义(P<0.05);观察组出科成绩、临床诊断思维病案标准化测试、中医量化临床演练评估考核成绩均高于对照组,差异均有统计学意义(P<0.05);调查问卷结果显示观察组中医四诊、辨证论治、体格检查、独立解决问题等方面的能力提高以及自主学习积极性、理论知识掌握程度均优于对照组,差异具有统计学意义(P<0.05)。结论将PDCA循环应用于中医全科住院医师的临床思维培训中,可提高住院医师的临床思维能力,提高住院医师对教学模式满意度。

Objective To study the application effect of PDCA cycle in the training of clinical thinking ability of Traditional Chinese Medicine(TCM)residents.Methods A total of 80 TCM residents rotating in the Department of General Practice in our hospital from January 2021 to January 2022 were selected and randomly divided into observation group and control group,with 40 in each group.The observation group combined PBL and situational simulation teaching method with general clinic,and used PDCA cycle to control the whole process of clinical thinking training.The control group adopted the traditional teaching method of classroom teaching and practice.The teaching effects of the two teaching modes were compared by using the test of completion examination,the standardized test of clinical diagnosis thinking record,the evaluation of quantitative clinical exercise of TCM,and the survey of teaching satisfaction.Results The teaching satisfaction of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The test scores of the observation group were higher than those of the control group,with statistical significance(P<0.05).The results of the questionnaire showed that the observation group was superior to the control group in improving the abilities of four TCM diagnosis,syndrome differentiation and treatment,physical examination,independent problem solving,independent learning enthusiasm and mastery of theoretical knowledge,and the differences were statistically significant(P<0.05).Conclusion The application of PDCA cycle in clinical thinking training of TCM residents can improve their clinical thinking ability and improve their satisfaction with teaching mode.