Application Research of Fragmented Case Teaching in Standardized Training of Residents in Anesthesiology Department

Objective:To explore the effect of fragmented case teaching in the standardized training of residents in anesthesiology department.Methods:80 doctors who participated in the standardized training of residents in anesthesiology department from January 2021 to January 2022 were selected as the research objects,and the 80 doctors were divided into experimental groups according to the clinical teaching mode(n=40,implemented case fragmented teaching method)and the control group(n=40,traditional teaching method).The training lasted for 2 months,and the medical history collection,medical record analysis,practical operation ability,theoretical assessment results,and the degree of satisfaction towards the training of the two groups of doctors were compared.Results:After 2 months of training,the theoretical knowledge and operational ability of the doctors in the two groups have improved to a certain extent,but the medical history collection,medical record analysis,practical operation ability,theoretical assessment results and satisfaction of the doctors in the experimental group were significantly better than those in the control group(P<0.05).Conclusion:The effect of the fragmented case teaching method in the standardized training of anesthesiology residents is significantly better than the traditional teaching mode.The abilities of doctors have significantly improved after the training.Hence,the fragmented case teaching method is worthy of promotion in clinical practice.

Effect Analysis of WeChat Platform Combined with PBL Teaching Method for Standardized Training of Residents in Anesthesiology Department

Objective: To explore and analyze the effect of the WeChat platform combined with the PBL teaching method in the standardized training of anesthesia residents. Methods: 120 anesthesiology residents from January 2018 to the end of December 2019 were selected, and divided into a control group and an observation group of 60 each according to the time sequence of admission. The control group adopted the conventional teaching mode, and the observation group adopted the WeChat platform combined PBL teaching method. The scores of theoretical knowledge and anesthesia skills operation after training, the scores of the teaching interest survey, and the satisfaction with the teaching mode between the two groups were compared. Results: The scores of theoretical knowledge and anesthesia skills operation in the observation group were significantly higher than those in the control group, and the indicators of teaching interest in the observation group were also higher than those in the control group. The differences were statistically significant (P < 0.05). The satisfaction degree of the observation group was significantly higher than that of the control group, and the difference was also statistically significant (P < 0.05). Conclusion: The WeChat platform combined with the PBL teaching method is beneficial to improve the training effect of anesthesiology residents, stimulating autonomous learning ability, ensuring the effective practice of theoretical knowledge, and promoting them to move towards a higher standard of anesthesia skills.

Availability and quality of procedural sedation and analgesia in emergency departments without emergency physicians: A national survey in the Netherlands

BACKGROUND: Emergency physicians have been successful in implementing procedural sedation and analgesia(PSA) to treat emergency department(ED) patients who need to undergo painful procedures.However, 25% of the EDs in the Netherlands are not staffed by emergency physicians.The aim of this study was to investigate PSA availability and quality in EDs without emergency physicians.METHODS: We performed an exploratory cross-sectional study amongst ED nurses and physicians in all 13 EDs without emergency physicians in the Netherlands.Data were gathered using a standardized questionnaire.RESULTS: The response rate was 34.3%(148/432).Of the respondents, 84/148(56.8%) provided adult PSA and 30/148(20.3%) provided paediatric PSA.Main reasons for not providing PSA were insufficient numbers of trained staff to support PSA in the ED and insufficient training and exposure.The providers agreed significantly stronger when reflecting their PSA competencies in adults compared to paediatric patients.CONCLUSION: The key to improve pain management in the ED-setting may lay in investing in continuous training of ED health care professionals and/or acquiring professionals who are both qualified in PSA and available in the ED.

Does shifting to professional emergency department staffing affect the decision for chest radiography?

BACKGROUND: The study aims to determine whether shifting to professional emergency department(ED) teams leads to a higher rate of radiologic workup.METHODS: We retrospectively analyzed a total of 2,000 patients presenting to the ED of a tertiary teaching hospital in two time periods: group 1(G1) comprised 1,000 consecutive patients enrolled from December 21, 2012 to January 5, 2013(all patients were examined by an internal medicine specialist);group 2(G2) comprised 1,000 consecutive patients enrolled from December 21, 2018 to January 3, 2019(all patients were examined by an emergency physician).RESULTS: The chest X-ray(CXR) was performed in 40.6% of all patients. There was no difference in the frequency of CXR(38.9% in G1 vs. 42.3% in G2, P=0.152). More CXRs were performed in G2 patients older than 65 years, in female patients older than 65 years, in patients presenting during the evening and night shifts or off-hours, in patients with a history of malignancy, in patients with gastrointestinal bleeding, and in patients with bradycardia, but fewer in patients presenting with arrhythmia. No difference in the rates of pathological CXR was found(47.3% in G1 vs. 52.2% in G2, P=0.186). Compared with G2, higher sensitivity and specificity were obtained for the binary logistic regression model predicting pathological findings in G1.CONCLUSIONS: Shifting to professional ED teams does not increase radiologic workup. By implementing deliberate usage of ultrasound, some self-governing procedures, case-oriented investigations, and center-specific recommendations, unnecessary radiologic workup can be avoided. Professional ED teams could lead to a higher standard of emergency care.

Emergency department visits:Why adults choose the emergency room over a primary care physician visit during regular office hours?

BACKGROUND:It has been estimated that up to one third of all emergency department(ED)visits may be"inappropriate"or non-emergent.Factors that have been speculated to be associated with non-emergent use have been noted to include low socioeconomic status,lack of access to primary care,lack of insurance,convenience of"on demand care"and the patient's individual perception of their complaint urgency.The objective of this study is to identify the reasons contributing to self-perceived non-emergent adult emergency department visits during primary care physician office hours of operation.METHODS:This study was a single-center,descriptive study with questionnaire.The questionnaire was collected from patients meeting exclusion/inclusion criteria who were triaged into an acute or fast track part of the emergency department during regular business hours on Monday through Friday,8:00 am-5:00 pm during the months of July 2011 and August 2011.Questionnaire data were categorical and summarized using counts and percentages.Data collected included patient demographics,information about the patient's primary care provider,and information about the emergency department visit in question.All responses were compared among patients with visits considered to be non-emergent to those considered to be emergent by using individual chi-square tests.RESULTS:There were 262 patients available for the study.The patients were grouped according to their perception of the severity of their complaints.Roughly half of the patients placed themselves into the non-emergent category(n=129),whereas the other half of the patients categorized themselves into the emergent group(n=131).There were statistically significant differences in marital status and employment status between the two groups.It was found that 61.5%of the non-emergent patients were single,while 58.3%of the emergent patients were married.In the non-emergent group,59.7%were unemployed,but in the emergent group 60.3%were employed(P<0.05).However,no other factors were significantly different.CONCLUSIONS:Our study did not identify a statistically significant factor to the reasoning behind why patients choose the emergency department over a primary care physician during regular office hours.The only significant demographic indicating who was more likely to make this choice during the specified time frame was being single and employed with perceived non-emergent complaint.Patients without insurance and/or without a primary care physician were no more likely to visit the emergency department with a self-perceived non-emergent issue than patients with insurance and/or with an established primary care physician.

Mini-CEX联合DOPS评分量表在推拿科住院医师规范化培训中的应用探索

目的采用迷你临床演练评估(mini-clinical evaluation exercise,Mini-CEX)联合临床技能操作评分量表(direct observation of procedural skills,DOPS)的形成性评价,探讨其在推拿科住院医师规范化培训教学中的应用价值。方法选取2022年6月—2023年6月在安徽中医药大学第一附属医院推拿科进行住院医师规范化培训的60名住院医师规范化培训学员,由获得安徽中医药大学住院医师规范化培训师资证书的教师进行临床规范化教学。在每期住培学员入科后1周及出科前利用Mini-CEX和DOPS评分量表各测评1次,通过对考核成绩、教师和学员互评满意度进行数据分析,评价形成性评价的临床教学效果。结果Mini-CEX量表的出科前考核成绩与入科后考核成绩[(54.95±4.17)分vs.(53.93±3.65)分]比较,差异均有统计学意义(P<0.05)。DOPS评分量表的出科前考核成绩与入科后考核成绩[(87.00±8.32)分vs.(84.97±6.75)分]比较,差异均有统计学意义(P<0.05)。出科前考核教师对评估结果的满意度分值高于入科后,出科前考核住培学员对评估结果的满意度分值高于入科后,差异均有统计学意义(P<0.05)。结论Mini-CEX结合DOPS评分量表作为推拿科住院医师规范化培训的形成性评价工具效果良好。

Improving Ordering Practices and Radiology Workflow in the Emergency Department through Multidisciplinary Didactic Series: Survey Based Evaluation

The purpose of our Quality Improvement (QI) project was to evaluate the effectiveness of radiology-led didactics on efficiency and ordering practices in the emergency department. Residents of the emergency medicine (EM) program at Downstate Medical Center/Kings County Hospital (postgraduate years 1 - 4) participated in a didactic lecture series during the first two months of the 2013 academic year. Two fifteen-minute lectures with a question and answer session were designed to focus on radiation risk, American College of Radiology (ACR) appropriateness criteria and the department of radiology’s policies. A short survey questionnaire that included questions on ACR appropriateness criteria, radiology experiences and opinions/attitudes regarding radiology was distributed and analyzed before and after the didactic series. The average score for the knowledge-based technical questions on ACR appropriateness criteria was 60.5% initially and 76.4% post-lecture with an overall improvement of 25%, which was statistically significant (p < 0.0001). Following a short didactic lecture series, EM residents showed significant improvement of their knowledge of appropriate image utilization on the post-lecture survey. This highlights the need for dedicated radiology-led lecture series for EM residents. This type of program could be implemented yearly and expanded to other departments to promote interdepartmental commuication, increases radiology awareness, improves ordering practices and encourages appropriate imaging utilization.

Effect of triage on physicians'clinical decision:A prospective,observational,single-center and cross-sectional study

Objective:To investigate the effect of the use of color codes for patient triage on physicians’clinical decision.Methods:This prospective study was conducted among female patients aged 18-65 years who visited the emergency department(ED)with complaints of acute abdominal pain.A 3-level of triage system[red(very urgent),yellow(urgent)and green(less urgent)]was used in our ED.All patients were green level.Half of these patients remained at the green level(the green group),and the remaining patients were re-labeled as false yellow(the false yellow group)in the order of ED visits.Ordering tests,consultation requests,intravenous treatment,length of hospital stay,and cost were compared between the two groups of patients.Results:In total 393 patients were included with 198 patients in the green group and 195 in the false yellow group.There was no statistically significant difference between the two groups in age,temperature,systolic blood pressure,diastolic blood pressure,pulse and oxygen saturation(P>0.05).It was observed that more tests(P=0.001),consultations(P<0.001),and intravenous treatment were requested(P<0.001),and the duration of stay in the ED was longer(P<0.001)and cost(P<0.001)was higher in the false yellow group.Conclusions:Triage do affect the decisions of physicians on female patients with acute abdominal pain.

A Lack of Effect on Patient Satisfaction Scores in One Large Urban Emergency Department

Background: To deal with emergency department crowding and long waits before patient care, many institutions have placed a doctor in the triage area to initiate treatment and testing. Objective: to determine the effect of a doctor in triage on patient satisfaction scores. Methods: This is an observational study comparing the patient satisfaction scores from days when a physician was in triage to days when a physician was not present. The study was conducted in the ED of an urban academic medical center with excellent primary care resources and payer mix (7% self pay, 11% Medicaid). Results: There was a mean of 4 (95% CI 3.1 - 4.5) surveys returned for each day when there was a doctor in triage and a mean of 5 (95% CI 4.3 - 5.7) surveys for each day without a doctor in triage. Overall satisfaction for the days with a doctor in triage was 79.9 ± 10.5 (95% CI 77.7, 82.1) compared to 78.8 ± 9.2 (95% CI 76.5, 81.1) (p = 0.9) on days without a doctor in triage. Conclusion: In this setting, there was no effect of a doctor in triage on patient satisfaction scores. While a doctor in triage may be valuable and cost effective in some settings, it may not provide appropriate benefit in all settings. We suggest that facilities trial a physician in triage program and measure predetermined outcomes such as patient satisfaction scores, length of stay and the percentage of patients left without being seen before investing in additional staffing and cost to sustain such a program.

Perceptions of Rural Emergency Department Providers regarding Telehealth-Based Care: Perceived Competency, Satisfaction with Care and Tele-ED Patient Disposition

Introduction: This study assesses rural providers’ perceptions of their ability to deliver high quality care via telehealth compared to usual care, and whether attending providers perceive that emergency department (ED) telehealth visits influence clinical reasoning in regard to patient disposition, specifically in tele-behavioral and tele-neurological cases. Methods: A cross-sectional survey was conducted of 134 ED providers (nurses [n = 126] and physicians [n = 8]) who were working in five Midwestern critical access hospitals (response rate 83%). Descriptive, correlational and stepwise regression analyses were employed to evaluate provider perceptions of 1) competency level in telehealth delivery, 2) patient health outcomes, 3) access to continuing education in telehealth, and 4) clinical influence of telehealth visit. Evaluation of preliminary set of N = 100 telehealth cases were assessed for influence of telehealth on clinical reasoning of attending physicians regarding patient disposition. Results: The majority (67%;n = 90) of participants had at least minimal experience with telehealth care delivery, with an average of 1 - 2 visits in teleneurology, and 3 - 4 visits in telebehavioral cases. Providers rated their overall mean competency level in telehealth care delivery as 3.01/5.00 based on a 5 point “novice (1) to expert” (5) scale. Mean scores for providers perceived competency level in 7 evidence-based sub-categories for telehealth care delivery were self-reported as relatively low to mid-range values, ranging from 2.64 - 3.57/5.00. Stepwise linear regression analysis of whether all providers “would recommend telehealth to their family and friends” revealed two predictors for model of best fit (n = 81;p 2 = 0.598): 1) their perceptions of telehealth experience compared to usual care;and 2) perceptions of patient health outcomes with telehealth compared to usual care. Providers rated “neutral” to “very unlikely” that they “would recommend telehealth to family and friends” (2.75/5.00;n = 122;91%). Attending physicians reported that for a majority of cases, telehealth visits influenced patient disposition and transfer decision-making (58.4%), and the influence of telehealth visits on patient disposition was statistically significantly higher for behavioral health cases (p Discussion: This study will be followed on to inform administrators/policy makers about 1) perceived level of competency of providers who implement tele-emergency care, 2) potential importance of telehealth equipment used and teamwork between rural providers and distant specialist, and 3) how use of telehealth may enhance ability of rural ED providers to improve quality of care. Perceived influence of telehealth on patient disposition is reported to be highest for telebehavioral patients. Healthcare educators need to place a priority on addressing provider competencies in telehealth through health professions degree programs and continuing education. Further research is needed to promote application and testing of evidence-based provider competencies in telehealth, and potentially relevant health communication models, to increase providers’ perceived efficacy and competency in telehealth care delivery, thus supporting high quality patient health outcomes.

Mini-CEX联合DOPS在心内科住院医师规范化培训中的应用

目的探讨迷你临床演练评估(mini clinical evaluation exercise,Mini-CEX)联合临床操作直接观察评估(direct observation of procedural skills,DOPS)在心内科住院医师规范化培训(以下简称住培)带教中的应用效果。方法将2020年7月—2022年1月在苏州大学附属张家港医院/张家港市第一人民医院心内科轮转的42名住培学员全部入选。带教老师团队学习并改良传统表格形成具有专科特色的Mini-CEX及DOPS表格,在心内科住培带教中在传统的教学方法基础上联合应用,入科时初评,出科时复评,对比两次测评的差异,并发放调查问卷总结应用中存在的问题、经验及满意度。结果Mini-CEX及DOPS考核,住培学员出科复评的成绩均高于入科初评时的成绩,差异有统计学意义(P<0.05);调查问卷结果显示大部分住培学员对MiniCEX及DOPS教学及考核给予了积极评价,认为新的教学模式对提高学员整体素质有帮助,有必要开展。结论Mini-CEX及DOPS作为一种内容全面,操作简便易行,注重人文关怀的新型教学和考评手段,对于提高心内科住培教学质量有效果,受到住培学员的一致好评。

Analysis of Misdiagnosis of Bipolar Disorder in An Outpatient Setting

背景:双相情感障碍是一种高误诊率的精神疾病,常被误诊为抑郁症、精神分裂症、焦虑症、强迫症和人格障碍等精神疾病,导致临床症状不能有效控制,病情呈反复发作趋势,故近年来双相情感障碍的误诊问题越来越引起精神科医生的重视。目的:了解双相情感障碍在门诊的误诊情况,并分析其误诊原因,指导临床医师加强对双相情感障碍的识别,尽量避免或减少其误诊和漏诊。方法:纳入专家门诊确诊为双相情感障碍的患者,了解其在门诊的就诊及误诊和漏诊情况,通过比较误诊组(包含漏诊者)和确诊组的临床资料进一步分析导致误诊和漏诊的可能原因。结果:双相情感障碍在专家门诊就诊患者中占31.5%。符合本研究入组标准的共有177例,其中误诊组136例(76.8%),确诊组41例(23.2%),误诊为抑郁症者最多(70.6%)。误诊组患者首次发作更多的表现为抑郁发作(χ~2=5.206,p=0.023),并且病程中抑郁发作次数更多(Z=-2.268,p=0.023);误诊组起病至首次治疗的时间较短(Z=-2.612,p=0.009)、而起病至确诊时间更长(Z=-3.685,p<0.001),总病程更长(Z=-3.274,p=0.001),并且住院治疗的患者更多(χ~2=4.539,p=0.033),住院次数也更多(Z=-2.164,p=0.031);误诊组伴有精神病性症状更多(χ~2=11.74,p=0.001),尤其抑郁发作时(χ~2=7.63,p=0.006),共病的发生率更高(χ~2=5.23,p=0.022);误诊组HCL-32评分更低(t=-2.564,p=0.011)。误诊组诊断为其他特定的双相及相关障碍的患者较确诊组多(11.0%v.4.9%),并且误诊组最近发作情况表现为抑郁发作的患者较多(78.7%v.65.9%)。结论:门诊双相情感障碍患者的误诊率高,常被误诊为抑郁症。误诊组患者首次发作更多的表现为抑郁发作,病程中抑郁发作次数更多,伴有精神病性症状更多,共病的发生率更高,并且患者对自身躁狂或轻躁狂发作情况明显认识不足,导致早期难以明确诊断,确诊所需时间更长,住院比率更高,住院次数更多。临床医生应提高对双相情感障碍的识别,避免或减少双相情感障碍的误诊和漏诊。

住培医师作为标准化病人的PBL教学法在神经内科教学中的应用

目的探讨住培医师作为标准化病人的以问题为导向的教学法(problem-based learning,PBL)在神经内科临床教学中的应用效果。方法采用随机数字表法,将2020年6月—2021年10月苏州大学附属第二医院62名正在培训的神经内科住培医师随机分成对照组(31名,传统教学法)和观察组(31名,住培医师作为标准化病人的PBL教学法)进行临床住培。从神经内科轮转期6个月以上住培学员中选取标准化病人培训对象。比较2组住培医师培训之后的理论知识、实践能力及综合素质评分。结果观察组住培医师的理论知识及实践操作成绩均高于对照组,差异有统计学意义(P<0.05);观察组住培医师的综合素质评分均高于对照组,差异有统计学意义(P<0.05)。结论住培医师作为标准化病人的PBL教学法在神经科临床培训教学中的应用效果显著。

临床病理科住院医师规范化培训的可视化分析

文章旨在探究我国临床病理科住院医师规范化培训相关研究的现状、研究热点和不足之处。基于中国知网数据库,借助VOSviewer、CiteSpace等软件,整理临床病理科住院医师规范化培训相关文献,从年发文量、地区分布、期刊分布、作者合作、关键词、机构合作等多角度进行可视化分析。研究发现:该领域的研究目前已进入快速增长期,研究热点集中在CBL、MDT等教学方式和导师制、分层培养、亚专业病理培训等培养模式的研究上,仍存在研究影响力不够高、东西部地区文献发表量差异大、各研究机构之间缺少交流和合作等问题。

检验医学科住院医师规范化培训教学中临床小讲课的设计、探索与体会

住院医师规范化培训是医学教育改革的重大举措,是医师成长的关键。临床小讲课是住院医师规范化培训教学工作的重要教学模式,是传授临床知识、培养住院医师临床思维、临床技能和实践能力、开拓临床医学专业视野的重要环节。随着住院医师规范化培训建设的进一步推进以及对检验医师培养的更深层次要求,如何更好地进行检验医学科的住培教育成为教学的关键问题。本文从检验医学科住院医师规范化培训的视角出发,以临床小讲课的目的与形式、特点、组织结构以及效果改进和评价四部分全面解读了临床小讲课指南,以讲授法案例、罕见和疑难案例、以问题为导向学习法(PBL)案例、思政教育以及翻转课堂等案例分享临床小讲课相关优秀案例经验,并对临床小讲课教学探索中的不足之处做出分析总结以及后续展望。在临床小讲课教学探索中发现,以临床小讲课为中心的检验住培教学能有效提高检验医师的循证思维能力、疾病诊治能力和学习能力,是检验医师培养中一种重要的、必要的、有效的教学模式。

首诊于精神科的脑淀粉样血管病1例

目的 探讨脑淀粉样血管病的临床症状及影像学表现。方法 回顾性分析1例首诊于精神科的脑淀粉样血管病的临床资料。结果 患者女性,56岁,临床主要表现为情感平淡、言语减少、记忆力减退。患者脑脊液蛋白0.51g/L,氯118.9mmol/L,潘氏试验弱阳性,脑电图α波不规则,慢波较多,磁敏感加权成像显示颅内弥漫性微出血,蒙特利尔认知评估11分,韦氏智力测试55分。给予甲强龙500 mg/d和罂粟碱90 mg/d治疗,出院2个月后复查,症状部分改善。结论 磁敏感加权成像对诊断脑淀粉样血管病具有较高的临床应用价值。

分层递进教学模式在普外科住院医师规范化培训中的应用探索

住院医师规范化培训是促进我国医学规范化发展,提高整体医疗卫生水平的重要途径。分层递进模式是国家对住院医师规范化培训工作提出的新要求,旨在满足不同阶段学员的诉求,有力地保障规范化培训的教学质量。普外科作为外科系统中的最大专科,具有技能操作多,知识涉及面广、学员人数多且能力水平不一等特点。分层递进教学模式在普外科的临床教学中具有重要的现实意义,是满足不同水平轮转学员要求的重要方式,也是各教学基地积极探索的重要领域。目前多家住培基地对分层递进教学模式进行了积极的尝试和探索,但有不同的认识和看法。北京朝阳医院普外科通过入科教育来摸清学员特点,在“三基”培训、科研能力培养、医德医风教育、出科考核内容等方面探索分层递进的具体措施并总结经验,希望能为分层递进教学工作的开展提供一定的参考。

联合教学模式在麻醉科住培中提升医师应急能力的应用效果

目的 探讨麻醉科住院医师规范化培训(以下简称“住培”)中紧急事件处理能力培训的方法与效果。方法 选择2019年1月—2021年12月在南京大学医学院附属鼓楼医院麻醉科接受规范化培训的40名住院医师作为数据研究对象,结合教学模式差异分为对照组与观察组,各20名。对照组采用传统病例讲解授课模式,观察组采用联合教学模式,比较2组考核成绩、问卷调查评分、教学满意度等情况。结果 观察组临床理论考试和临床应急案例分析考试成绩均高于对照组,差异有统计学意义(P <0.05);观察组印象深刻程度、分析全面性、学员参与度、教学吸引力和教学生动性等问卷调查评分均高于对照组,差异有统计学意义(P <0.05);观察组应变能力、沟通能力、团队合作、临床操作水平、临床思维能力等满意度均高于对照组,差异有统计学意义(P<0.05);观察组医师资格考试和规范化培训结业考试通过率都高于对照组,差异有统计学意义(P <0.05);观察组第一学年、第二学年和第三学年的理论知识与实践能力考核成绩均高于对照组,差异有统计学意义(P<0.05)。结论 麻醉科住院医师规范化培训临床紧急事件处理教学中应用联合教学模式,可以获得比较理想的培训效果,有助于规范化培训医师理论和实践能力的提升,且培训满意度较高。

麻醉科规范化培训超声引导下神经阻滞教学效果分析

目的讨论麻醉科规范化培训超声引导下神经阻滞教学中的效果。方法选择2019年1月—2022年12月鄂尔多斯市中心医院麻醉科接受规范化培训的40名住院医师为研究对象,以分层抽样法随机分为对照组与研究组,各20名。对照组规范化培训超声引导下神经阻滞教学采取常规教学模式,研究组规范化培训超声引导下神经阻滞教学采取常规教学模式+微课教学法。观察理论知识考核情况、技术操作考核情况、教学模式评价度。结果研究组理论基础知识[(47.58±3.22)分]、论述及病例分析[(47.68±3.50)分]、总分[(94.68±4.28)分]均高于对照组[(45.25±3.77)、(40.25±4.28)、(85.34±5.70)分],差异有统计学意义(P<0.05)。研究组技术操作考核成绩[(95.67±4.81)分]高于对照组的技术操作考核成绩[(80.65±5.33)分],差异有统计学意义(P<0.05)。研究组麻醉效果优良性为95%,高于对照组的70%,差异有统计学意义(P<0.05)。研究组记忆解剖内容[(17.25±1.25)分]、便于随时随地了解知识点[(17.92±1.22)分]、激发学习兴趣度[(18.25±1.32)分]、临床操作技术水平自评[(16.82±1.85)分]、临床麻醉效果满意度自评[(18.35±1.11)分]评分均高于对照组[(12.81±2.35)分、(10.75±2.22)分、(13.68±2.61)分、(13.28±2.58)分、(16.82±1.00)分],差异有统计学意义(P<0.05)。结论麻醉科住院医师规范化培训超声引导下神经阻滞教学中实施微课教学法,利于提高理论知识及技术操作考核结果,且该教学模式已得到麻醉科住院医师的认可及满意。

妇产科住培教学方法改革探索

为进行妇产科住培教学改革,提升妇产科住培医生的综合素质和实践能力,文章通过文献总结并分析当前妇产科住培现状,按照国家《关于加强医学教育工作提高医学教育质量的若干意见》,结合笔者在教学大赛中的具体做法,提出以病例为导向,采用沉浸式情景模拟教学、以问题为基础的教学法(problem-based learning,PBL)等多种教学法在妇产科住培理论教学中的应用;建议采用分层培养模式进行妇产科人才实践能力的培养,以满足不同层次人才的成长需要。为提高医学人才培养质量,加强妇产科人才队伍的建设,在理论教学及临床实践能力培养中挖掘、提炼妇产科课程中所蕴含的思政元素,推进妇产科教学模式改革,高质量地完成妇产科住培教育工作,以期更好地完成培训目标,满足新时代人才培养需要。