产后出血MDT急救模拟培训在产科实习医师教学中的应用

Application of MDT and first aid imitation training in teaching interns at department of obstetrics

目的探讨产后出血多学科协作(MDT)急救模拟培训在产科实习医师教学中的应用效果。方法本研究采用试验对照方法,选取2022年5月至2023年4月在中山大学附属第三医院产科实习的中山大学临床医学专业学生作为研究对象,按照信封随机法将其分为试验组和对照组。其中,试验组共49名,男23名,女26名,年龄(22.59±0.53)岁;对照组共50名,男29名,女21名,年龄(22.44±0.50)岁。试验组在参与中山大学附属第三医院产科实习的同时,进行产后出血MDT急救模拟培训;对照组仅参与产科实习。发放调查问卷进行各项能力的自我评估,比较两组的教学效果。计量资料采用t检验,计数资料采用χ^(2)检验或配对χ^(2)检验。结果试验组发放调查问卷49份,回收49份,对照组发放调查问卷50份,回收50份,有效问卷回收率为100.0%。试验组有73.5%(36/49)的实习医师认为参与产后出血MDT急救模拟培训课程为深入了解MDT提供了很大帮助。试验组参与培训后与对照组产科实习结束前的调查问卷显示,试验组对产科临床诊断能力、产科单项操作能力、其他学科诊断能力、其他学科单项操作能力、对多学科诊疗思维能力、对综合急救操作能力的欠缺率均低于对照组[0比44.0%(22/40)、6.1%(3/49)比52.0%(26/50)、8.2%(4/49)比38.0%(19/50)、6.1%(3/49)比44.0%(22/50)、2.0%(1/49)比58.0%(29/50)、8.2%(4/49)比82.0%(41/50)],差异均有统计学意义(均P<0.001)。结论产后出血MDT急救模拟培训课程能够加深实习医师对MDT的了解,实现提升实习医师的多学科诊疗思维、综合急救操作能力等课程目标。

Objective To explore the effect of the application of multi-disciplinary team(MDT)and first aid imitation training in teaching interns at department of obstetrics.Methods Ninety-nine interns majoring in clinical medicine at Sun Yat-sen University and practicing at Department of Obstetrics,Third Hospital,Sun Yat-sen University from May 2022 to April 2023 were selected for the randomized controlled trial,and were divided into an experimental group(49 interns)and a control group(50 interns)by the envelope random method.There were 23 males and 26 females in the experimental group;they were(22.59±0.53)years old.There were 29 males and 21 females in the control group;they were(22.44±0.50)years old.Both groups took practice at Department of Obstetrics,Third Hospital,Sun Yat-sen University;in addition,the experimental group took MDT and first aid imitation training for postpartum hemorrhage.By sending questionnaires to the experimental group and the control group for self-assessment of various abilities,the teaching effects of the two groups were compared.t test was used for the measurement data,andχ^(2) test or pairedχ^(2) test for the enumeration data.Results All the questionnaires in both groups were recovered,and the recovered rates both were 100.0%.In the experimental group,73.5%(36/49)interns believed that participating in the MDT and first aid imitation training for postpartum hemorrhage helped them understand MDT in-depth.The questionnaire investigation after the training for the experimental group and before the obstetric pactice in the control group showed that.The rates lacking clinical obstetric diagnosis ability,single-item obstetric operation ability,diagnosis ability in other disciplines,single-item operation ability in other disciplines,multi-disciplinary diagnosis and treatment thinking,and comprehensive first aid operation ability in the experimental group were lower than those in the control group[0 vs.44.0%(22/40),6.1%(3/49)vs.52.0%(26/50),8.2%(4/49)vs.38.0%(19/50),6.1%(3/49)vs.44.0%(22/50),2.0%(1/49)vs.58.0%(29/50),and 8.2%(4/49)vs.82.0%(41/50)],with statistical differences(all P<0.001).Conclusion MDT and first aid imitation training for postpartum hemorrhage can enhance the interns'understanding of MDT,and improve their multidisciplinary diagnosis and treatment thinking and comprehensive emergency operation ability.