目的探究成果导向教育(Outcome Based Education,OBE)理论下TPA阶梯教学对神经科医师培训效果及教学满意度的影响。方法随机选取2020年5月—2023年5月潍坊医学院附属医院接受规范化培训的52名神经科医师为研究对象,于2020年5月—2021年1...目的探究成果导向教育(Outcome Based Education,OBE)理论下TPA阶梯教学对神经科医师培训效果及教学满意度的影响。方法随机选取2020年5月—2023年5月潍坊医学院附属医院接受规范化培训的52名神经科医师为研究对象,于2020年5月—2021年12月培训中采用传统教学法的26名医师为A组、于2022年1月—2023年5月培训中采用OBE理论下TPA阶梯教学的26名医师为B组,对比两组培训效果。结果教学后,B组理论考核成绩、实践能力考核成绩均高于A组,差异有统计学意义(P均<0.05);B组教学满意度(100.00%)高于A组(76.92%),差异有统计学意义(χ^(2)=4.710,P<0.05)。结论OBE理论下TPA阶梯教学的应用效果更理想,有助于提高神经科医师理论及实践能力考核成绩、教学满意度。展开更多
Objective: To compare the ability of a headache nurse specialist and consultant neurologists in diagnosing tensiontype headache and migraine. Methods: An experienced neurology ward sister was trained in the differen...Objective: To compare the ability of a headache nurse specialist and consultant neurologists in diagnosing tensiontype headache and migraine. Methods: An experienced neurology ward sister was trained in the differential diagnosis of headache disorders. Over six months, patients with nonacute headache disorders and role players trained to present with benign or sinister headaches were seen by both the nurse and a consultant neurologist. Both reached independent diagnoses of various headache disorders. Results: Consultants diagnosed 239 patients with tensiontype headache (47%), migraine (39%), or other headache disorders (14%). The nurse agreed with the consultant in 92%of cases of tensiontype headache, 91%of migraine, and 61%of other diagnoses. Where the nurse did not agree with the diagnosis, most would have been referred for a consultant opinion. Both the nurse and the doctors misdiagnosed the same three of 13 role players. The investigation rate of the consultants varied between 18%and 59%. Only one clinically relevant abnormality was found on head scans and this was strongly suspected clinically. Conclusions: A headache nurse specialist can be trained to diagnose tensiontype headache and migraine. A nationwide nurse led diagnostic headache service could lead to substantial reduction in neurology waiting times.展开更多
目的在神经科住院医师中开展困难谈话技能培训课程,探究困难谈话技能培训的可行性,并初步探索本课程的效果。方法在北京协和医院神经科住院医师中开展2次困难谈话技能培训课程,每月1次,每次2 h。课程主题均为与神经科临床实践相关的具...目的在神经科住院医师中开展困难谈话技能培训课程,探究困难谈话技能培训的可行性,并初步探索本课程的效果。方法在北京协和医院神经科住院医师中开展2次困难谈话技能培训课程,每月1次,每次2 h。课程主题均为与神经科临床实践相关的具体临床情景,包括:(1)告知坏消息;(2)与“困难”患者或家属沟通;(3)讨论不施行心肺复苏等抢救措施;(4)与家属讨论重症患者的临终关怀。采用情景模拟教学方法,邀请标准化病人和住院医师在教师指导下完成案例情景模拟,并进行医患沟通伦理知识、技能策略的学习。采用匿名在线调查评估住院医师对本课程的满意度,课程前后采用困难谈话技能自我评估问卷分析住院医师11个维度技能的改善情况。课程结束1年后使用医患沟通技能评价量表(set the stage,elicit information,give information,understand the patient’s perspective,and end the encounter;SEGUE)对部分住院医师的沟通能力进行考核。结果共有14位住院医师参加了困难谈话技能培训课程,12位(85.7%)完成了相关调查评估问卷。完成问卷的住院医师中9位(75.0%)为女性,10位(83.3%)为低年级住院医师(第一年或第二年住院医师)。总体而言,住院医师对本课程反响积极,所有完成问卷的住院医师均对课程表示满意;参与的住院医师在困难谈话技能自我评估问卷涉及的绝大多数维度上均有不同程度改善;4位住院医师完成SEGUE评估,3位获得A级评分。结论在神经科住院医师中使用基于真实病例的特定临床情景模拟来开展困难谈话技能培训课程是可行的,住院医师对课程满意度高且课程对其有积极影响,住院医师的困难谈话技能在培训后得到一定提升。展开更多
文摘目的探究成果导向教育(Outcome Based Education,OBE)理论下TPA阶梯教学对神经科医师培训效果及教学满意度的影响。方法随机选取2020年5月—2023年5月潍坊医学院附属医院接受规范化培训的52名神经科医师为研究对象,于2020年5月—2021年12月培训中采用传统教学法的26名医师为A组、于2022年1月—2023年5月培训中采用OBE理论下TPA阶梯教学的26名医师为B组,对比两组培训效果。结果教学后,B组理论考核成绩、实践能力考核成绩均高于A组,差异有统计学意义(P均<0.05);B组教学满意度(100.00%)高于A组(76.92%),差异有统计学意义(χ^(2)=4.710,P<0.05)。结论OBE理论下TPA阶梯教学的应用效果更理想,有助于提高神经科医师理论及实践能力考核成绩、教学满意度。
文摘Objective: To compare the ability of a headache nurse specialist and consultant neurologists in diagnosing tensiontype headache and migraine. Methods: An experienced neurology ward sister was trained in the differential diagnosis of headache disorders. Over six months, patients with nonacute headache disorders and role players trained to present with benign or sinister headaches were seen by both the nurse and a consultant neurologist. Both reached independent diagnoses of various headache disorders. Results: Consultants diagnosed 239 patients with tensiontype headache (47%), migraine (39%), or other headache disorders (14%). The nurse agreed with the consultant in 92%of cases of tensiontype headache, 91%of migraine, and 61%of other diagnoses. Where the nurse did not agree with the diagnosis, most would have been referred for a consultant opinion. Both the nurse and the doctors misdiagnosed the same three of 13 role players. The investigation rate of the consultants varied between 18%and 59%. Only one clinically relevant abnormality was found on head scans and this was strongly suspected clinically. Conclusions: A headache nurse specialist can be trained to diagnose tensiontype headache and migraine. A nationwide nurse led diagnostic headache service could lead to substantial reduction in neurology waiting times.
文摘目的在神经科住院医师中开展困难谈话技能培训课程,探究困难谈话技能培训的可行性,并初步探索本课程的效果。方法在北京协和医院神经科住院医师中开展2次困难谈话技能培训课程,每月1次,每次2 h。课程主题均为与神经科临床实践相关的具体临床情景,包括:(1)告知坏消息;(2)与“困难”患者或家属沟通;(3)讨论不施行心肺复苏等抢救措施;(4)与家属讨论重症患者的临终关怀。采用情景模拟教学方法,邀请标准化病人和住院医师在教师指导下完成案例情景模拟,并进行医患沟通伦理知识、技能策略的学习。采用匿名在线调查评估住院医师对本课程的满意度,课程前后采用困难谈话技能自我评估问卷分析住院医师11个维度技能的改善情况。课程结束1年后使用医患沟通技能评价量表(set the stage,elicit information,give information,understand the patient’s perspective,and end the encounter;SEGUE)对部分住院医师的沟通能力进行考核。结果共有14位住院医师参加了困难谈话技能培训课程,12位(85.7%)完成了相关调查评估问卷。完成问卷的住院医师中9位(75.0%)为女性,10位(83.3%)为低年级住院医师(第一年或第二年住院医师)。总体而言,住院医师对本课程反响积极,所有完成问卷的住院医师均对课程表示满意;参与的住院医师在困难谈话技能自我评估问卷涉及的绝大多数维度上均有不同程度改善;4位住院医师完成SEGUE评估,3位获得A级评分。结论在神经科住院医师中使用基于真实病例的特定临床情景模拟来开展困难谈话技能培训课程是可行的,住院医师对课程满意度高且课程对其有积极影响,住院医师的困难谈话技能在培训后得到一定提升。
