基层医师临床操作技能网络远程教学培训的探索与思考

Exploration and Thinking of Network Distance Teaching and Training of Clinical Operation Skills for Primary Doctors

目的 探讨在移动互联网模式下通过远程教学培训模式对提高基层医师临床操作技能的有效性。方法 选取四川省甘孜地区基层卫生医疗机构的基层医师共128名,随机1:1分为试验组(n=64)和对照组(n=64),其中试验组采用线下、线上及视频会议结合的混合模式培训并采取在线培训和考核,对照组采用线下传统模式培训,两组每次培训时间为3学时,1周2次。培训4周后两组人员均接受面授视频和自主训练2周,通过线上发放问卷并在线视频考核,并对问卷进行回收分析及成绩分析,观察和评估两组培训后的效果。结果 在理论考核和技能操作考核上,两组均全部达到培训合格,试验组两项考核项目成绩明显高于对照组(P<0.05)。另外在课程满意度调查问卷评分比较中发现,无论从视频播放流畅度等调查问卷的客观指标、还是教师讲解清晰度、课程难易程度、课程设置是否合理、课程内容是否掌握等调查问卷的主观指标,两组均可达到一般程度以上,但试验组明显优于对照组,差异有统计学意义(P<0.05)。结论 对基层医师临床操作技能的远程教学培训模式,包括基本临床技能、专科临床技能、综合临床技能和临床情景培训等,采用问卷调查和在线视频考核方式进行分析,完善培训课程内容及流程,使基层医务人员可以根据自身的不同情况,有针对性地选择学习,从而提高基层医务人员的医疗服务水平,达到更好地为人民健康服务的目的。

Objective To explore the effectiveness of remote teaching and training mode through online and video conference-based training in improving the clinical operational skills of primary care physicians in the context of mobile internet and network mode.Methods A total of 128 primary care physicians from healthcare institutions in Ganzi Prefecture,Sichuan Province,were randomly divided into an experimental group(n=64)and a control group(n=64)in a 1:1 ratio.The experimental group received a mixed mode of online and video conference-based training,with online training and assessment,while the control group received traditional offline training.Both groups had training sessions of 3 school hours,twice a week.After 4 weeks of training,both groups received face-to-face video sessions and autonomous training for 2 weeks.Online questionnaires and video assessments were conducted to evaluate the training effects,and the collected data were analyzed and compared.Results Both groups achieved a pass in the theory and operational skills assessments,but the experimental group performed significantly better than the control group in terms of assessment scores(P<0.05).Furthermore,in the satisfaction survey,the experimental group outperformed the control group in terms of objective indicators such as video playback smoothness,as well as subjective indicators such as teacher clarity,course difficulty,course appropriateness,and mastery of course content(P<0.05).Conclusion Remote teaching and training mode for the clinical operational skills of primary care physicians,including basic clinical skills,specialized clinical skills,comprehensive clinical skills,and clinical scenario training,can be effectively delivered through 3 school hours of online training.By analyzing and improving the training content and process,primary healthcare staff can selectively learn based on their specific needs,thereby enhancing their professional skills and service quality,and ultimately better serving the people's health.