融入引导式反馈的模拟教学在提升儿科住院医师技能培训中的应用——以腰椎穿刺为例

Application of simulation training with debriefing in improving the skills training of pediatric residents:a case study of lumbar puncture

目的探讨融入引导式反馈的模拟教学在儿科住院医师腰椎穿刺技能培训中的应用效果。方法在2020年7月—2022年7月进入复旦大学附属儿科医院儿科专业基地的第一年住院医师中,随机选取31名作为观察组,采取引导式反馈教学法;29名作为对照组,采取传统教学方法。比较两组的前测理论及操作考试成绩和课程结束后后测的理论及操作考试成绩,并对培训课程的反馈进行问卷调查分析。结果采用两种教学方法培训后,住院医师的理论和操作成绩均有提升,差异具有统计学意义(均P<0.05);观察组的理论与操作成绩均高于对照组,差异具有统计学意义(均P<0.01)。问卷调查结果显示,观察组在课程内容实用性、对临床工作的帮助、培训后技能提高程度和课程推荐程度等方面的评价高于对照组,差异具有统计学意义(均P<0.05);在课程安排合理性方面两组差异无统计学意义。结论融入引导式反馈的模拟教学效果良好,有助于提升住院医师的自信心,提高住院医师对操作的掌握程度。

Objective To explore the application effect of debriefing in the lumbar puncture skills training of pediatric residents.Methods Among the first-year residents who entered the pediatric training base of Children's Hospital of Fudan University from July 2020 to July 2022,31 residents who received the debriefing teaching method were randomly selected as the observation group,and 29 residents who received the traditional teaching method were randomly selected as the control group.The results of the theory and operation pre-test and the theory and operation post-test were compared between the two groups of residents,and the feedback of the training course was analyzed by the questionnaire survey.Independent sample t test and Wilcoxon rank sum test were used to compare test scores and questionnaire results.Chi-square test was used to compare baseline data differences.Results After using the two teaching methods,the theoretical and operational scores of residents were improved,with statistical significance(all P<0.05).The improvement degrees of theoretical and operational scores of observation group were higher than those of control group,with statistical significance(all P<0.001).The results of the questionnaire showed that the evaluations of the observation group were higher than those of the control group in the aspects of the practicability of the course,the assistance in clinical work,the improvement of skills after training,and the degree of course recommendation,with statistical significance(all P<0.05).There was no statistical difference between the two groups in the rationality of the course arrangement.Conclusions The simulation teaching with debriefing has good effect,which is helpful to improve the confidence of residents and improve their mastery of the operation.This model is more acceptable to residents and has good application effect,which is worthy of further research and promotion.