Exploring the Application Effect of Flipped Classroom Combined with Problem-Based Learning Teaching Method in Clinical Skills Teaching of Standardized Training for Resident Doctors of Traditional Chinese Medicine

Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.

Application Effect of Remote Ultrasound Teaching in Standardized Residency Training

Objective:To explore the application effect of remote ultrasound teaching in the standardized training of residents.Methods:42 students who participated in the standardized residency training in the Department of Ultrasonography of our hospital from August 2022 to August 2023 were selected and divided into the control group(n=21)and the observation group(n=21)by using the random number table method.The control group was taught routinely,and the observation group was taught with remote ultrasound on the basis of the control group.The general data,teaching effect,ultrasound diagnostic compliance rate,and teaching satisfaction of the participants in the two groups were observed.Results:The baseline data of the two groups were not statistically significant(P>0.05);the theoretical and practical assessment scores of the observation group were significantly better than those of the control group(t=2.491,t=2.434,P=0.05);the ultrasound diagnostic compliance rate of the participants in the observation group was significantly higher than that of the control group(78.33%)(χ2=33.574,P=0.000<0.001);the overall satisfaction rate of students in the observation group(20/95.24%)was significantly higher than that of the control group(14/66.67%)(χ2=3.860,P=0.049<0.05).Conclusion:In standardized residency training,remote ultrasound teaching can effectively improve the comprehensive ability of students,enhance diagnostic accuracy,and improve students’teaching satisfaction.

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.

Effectiveness of Participatory Teaching Methods in the Standardized Training of Respiratory Medicine Residents

Objective:To explore and analyze the application effect of participatory teaching method in the standardized training of respiratory medicine residents.Methods:The study period was from May 2022 to May 2023.20 doctors in the standardized training of respiratory medicine residency in our hospital were taken as research subjects and grouped into the participatory group(n=10)and the routine group(n=10)by using the random number lottery method.The participatory group practised participatory teaching methods,and the routine group practised routine teaching methods.The results of discharge assessment,teaching evaluation,and mini-Clinical Evaluation Exercise(mini-CEX)assessment were compared between the groups.Results:The theoretical assessment,operational assessment,and total scores of the participatory group were significantly higher than those of the routine group,and the difference was statistically significant(P<0.05).The teaching evaluation of independent learning,theoretical mastery,teamwork,clinical thinking,communication,and learning interest of the participatory group was significantly higher than that of the routine group,and the difference was statistically significant(P<0.05).The mini-CEX assessments of history inquiry,organizational effectiveness,professionalism,physical examination,clinical diagnosis,communication skills,and overall clinical competence of the participatory group were significantly better than those of the routine group,and the difference was statistically significant(P<0.05).The teaching satisfaction of the participatory group was significantly higher than that of the routine group,the difference was statistically significant(P<0.05).Conclusion:Participatory teaching methods can improve the overall level of doctors in the respiratory medicine residency standardized training,and the teaching satisfaction is improved.

Preliminary Study on the Training Mode of Chinese Pharmacy Professionals Based on the National Standard of Teaching Quality

With the promulgation of the National Standard for the Teaching Quality of Undergraduate Majors in Ordinary Colleges and Universities, the state has made clear regulations on the standard for the cultivation of Chinese pharmacy talents. Based on their own actual conditions, major colleges and universities have implemented different talent training modes, including talent training modes of running talent classes, "2+1+1", "Chinese Medicine Research Practice Class", employment-oriented professional talent training mode, three-level three-type diversified talent training mode, and talent training mode oriented with adapting to the characteristics of ethnic regions. Various talent training modes have different training objectives, and corresponding training programs are formulated to meet the requirements of the National Standard for the Teaching Quality of Undergraduate Majors in Ordinary Colleges and Universities. In addition, according to the notice on Solidly Promoting Labor Education into the "National Standard for the Teaching Quality of Undergraduate Majors in Ordinary Colleges and Universities" issued by the Department of Higher Education of the Ministry of Education, the introduction of labor education to the teaching of Chinese pharmacy majors will be a trend, and Chinese pharmacy professionals are required to achieve comprehensive and coordinated development of morality, intelligence, physique, beauty, and labor. How to integrate labor education with high quality and high efficiency into the training of Chinese pharmacy professionals is a problem that major universities will think about.

5A教学模式在普通外科住院医师规范化培训中的应用

目的探讨5A教学模式在普通外科住院医师规范化培训中的应用效果。方法采用随机对照研究方法,以2020年1月至2022年12月在解放军总医院第一医学中心普通外科医学部接受住院医师规范化培训并进入本研究团队主诊组轮转学习的学员为研究对象,随机分为试验组和对照组。试验组20名,采用5A教学模式;对照组20名,采用传统教学模式。对2组学员进行理论考核、临床技能考核和综合能力考核,记录考核成绩,并比较2组的教学效果。结果相对于对照组,试验组学员在消毒铺巾、切开缝合和腔镜技能考核3个方面的成绩得到提高,差异有统计学意义(P<0.05);试验组学员在团队协作和科学研究2个方面的成绩高于对照组,差异有统计学意义(P<0.05);试验组学员带教满意度高于对照组,差异有统计学意义(P<0.05)。结论5A教学模式可以显著提高学员的临床实践操作、团队协作和科学研究能力,可作为普通外科住院医师规范化培训的有效教学方法。

教师模拟标准化病人联合临床医师技能培训考试系统教学模式应用于住院医师规范化培训中的效果

目的探讨教师模拟标准化病人(TSP)联合临床医师技能培训考试系统(OSCE)教学模式应用于住院医师规范化培训(以下简称“规培”)中的效果。方法选取2022年8月至2023年8月在潍坊医学院附属医院接受规培的住院医师60名,按随机抽签法分为两组,对照组30名培训过程中应用传统教学模式,研究组30名培训中应用TSP联合OSCE教学模式。比较两组规培医师培训前后的培训效果、综合能力及对规培医师对教学模式认同度。结果研究组培训后的理论、实践操作成绩均高于对照组,差异有统计学意义(P<0.05)。研究组培训后的迷你临床演练评估(Mini-CEX)、批判性思维能力测量表(CTDI-CV)评分均高于对照组,差异有统计学意义(P<0.05)。研究组规培医师对教学模式的认同度高于对照组,差异有统计学意义(P<0.05)。结论TSP联合OSCE教学模式应用于住院医师规培中可有效提升其成绩及综合能力,且规培医师对此教学模式的认同度较高。

应用临床教学五步法进行形成性评价提升住院医师医患沟通能力

目的研究应用临床教学五步法进行形成性评价提升住院医师医患沟通能力。方法采用自身对照的队列研究方法,由参与研究的指导医师对自愿纳入研究的住院医师进行5次关于医患沟通技能的形成性评价,每次均应用临床教学五步法进行反馈指导。对形成性评价前后住院医师的自评和他评结果进行对比分析。结果21名住院医师纳入研究。第5次形成性评价得分(90.00±2.47)分与第1次得分(61.24±9.86)分相比,差异有统计学意义(P<0.01)。18名住院医师完成自评问卷,结果提示,应用临床教学五步法进行形成性评价后,住院医师更注意在沟通前了解患方的社会文化背景,并据此拟定不同沟通策略。在沟通中,住院医师更注意观察患者的表情和语气的变化,主动询问患者的理解程度、治疗期望和意愿(P<0.05)。结论应用教学五步法进行形成性评价可有效提升住院医师医患沟通能力。

全科住院医师规范化培训师资开展教学门诊的意愿及影响因素研究

背景全科住院医师规范化培训(以下简称住培)师资开展规范的教学门诊是培养合格全科医生的关键环节,2021年7月中国医师协会组织专家修订了《全科专业住院医师规范化培训全科教学门诊规范(试行)》,全国各全科住培基地均参照此规范开展教学门诊。然而现阶段各住培基地教学门诊的实施仍处于探索阶段,且重视程度不足,教学门诊质量不高、开展形式不规范现象普遍存在。目的了解全科住培师资开展教学门诊的意愿和影响因素,并分析开展教学门诊的难点与困惑,提出思考与建议。方法于2021年10月—2023年11月,以参加广东省省级全科住培普通师资培训班、骨干师资培训班的全科住培师资为调查对象(n=1003)。采用自行设计的问卷对纳入师资进行调查,内容涉及师资的基本情况、工作情况及全科教学门诊带教情况。通过“问卷星”平台制作电子问卷,并实现问卷的线上发放和回收。结果全科师资的平均年龄为(40.7±14.1)岁,724名(72.18%)师资所在机构开设了全科教学门诊,792名(78.96%)有带教意愿,710名(70.79%)无带教经验,904名(90.13%)自评带教能力为60~89分,583名(58.13%)未接受过全科教学门诊师资培训,462名(46.06%)期望以多种类型培训相结合的形式开展师资培训,分别有417名(41.58%)和309名(30.81%)认为全科教学门诊的教学难点是指导全科住院医师在全科门诊独立接诊患者和分层教学,377名(37.59%)认为最难实现的教学目的是指导全科住院医师掌握全科临床思维、提高其临床决策能力,216名(21.54%)认为全科住院医师最需要的培训内容是问诊技巧,456名(45.46%)认为所在机构未开展/不愿意开展教学门诊的原因为缺乏时间。多因素Logistic回归分析结果显示,所在机构开设全科教学门诊情况、带教经验、自评带教能力、接受全科教学门诊师资培训情况是全科师资教学门诊带教意愿的影响因素(P<0.05)。结论大部分全科住培师资愿意开展全科教学门诊,但存在带教经验、带教培训、带教能力不足等困难。建议优化和规范全科教学门诊、加强全科教学门诊师资的全科理念培训、强化带教激励措施、完善住培师资监督和反馈机制,以提升全科教学门诊质量。

360度评估在某三甲妇幼保健院妇产科专业住培管理中的应用

目的 为了解住院医师和带教老师在培训中存在的问题,加强住培过程管理,提升培训质量。方法 在某省妇幼保健院妇产科住培专业基地组织360度评估,共有住院医师636人次、带教老师602人次和护理人员361人次完成评估。结果 评估问卷信度效度评价指标均在0.95以上,具有较高的可靠性。带教老师对住院医师的评估结果提示,被评估住院医师在职业精神[(4.7±0.5)分]、患者照护[(4.6±0.6)分]和沟通合作[(4.6±0.7)分]维度获得较高得分,在知识技能[(4.2±0.8)分]和教学能力[(4.1±0.8)分]维度得分较低。对评估分数进行单因素分析,带教老师对住院医师的评估中,高年级得分高于低年级(F=4.29,P<0.05),但不同年级住院医师对带教老师的评估差异无统计学意义(F=0.098,P> 0.05),不同护理人员对住院医师的评估差异无统计学意义(F=0.151,P>0.05)。在三类评估中,对带教老师评估的平均得分虽然最高[(96.5±8.3)分],但主观反馈中,住院医师给带教老师提出教学时间不够,教学意识不强等具体建议。结论 应用360度评估工具,有利于师生发现问题、解决问题,也为专业基地制定培养计划和规范过程管理提供参考依据。

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。

基于模糊综合评判的住院医师规范化培训带教质量评价

带教质量直接影响住院医师规范化培训工作中最终输出人才的质量,对带教质量进行合理、有效的评价,是提升住院医师规范化培训质量、完善住院医师规范化培训制度的重要保证。针对住院医师规范化培训工作中带教质量评价因素的复杂性、模糊性以及定性指标难以量化的问题,提出一种基于模糊综合评判的带教质量评价方法。首先,进行一级评判,通过确定因素集、评价集,进行单因素评价,再确定各因素的权重,进行综合评价;其次,进行二级或多级综合评判,构建基于模糊综合评判的带教质量评价模型;最后,通过带教质量的模糊综合评价实例,对带教质量的评价方法进行研究。

浅谈住院医师规范化培训的心电图实践教学

住院医师规范化培训(简称住培)是目前较受认可的培养合格临床医师的方式,而心电图作为一项重要的临床常规检查,是临床医生必须掌握的基本技能之一,也是住培中要求掌握的重要内容。昆明医科大学第二附属医院心功能科在不断完善和改进中摸索出了一套更适合住培学员的教学方式,利用多元化的教学形式增强学员学习兴趣,保证学习质量,从而使其更好地将所学知识和技能应用于临床。

精准时代下住院医师规范化培训方法初探

随着整个社会“精准”理念的不断提出,精准时代的概念逐渐形成,而互联网、大数据、人工智能等的快速发展也为精准理念提供了更有力的保障。住院医师规范化培训以立德树人为引导,以培养岗位胜任力为目标,教与学都要力争“精准”。因此,可以将“精准医学”“精准教学”等理论体系引入住院医师规范化培训中,针对不同的学员层次制订精准合理的教学目标和个体化教学方案,对学生的基本信息和既往学习背景进行全面了解、分析,从而精准把控学情。结合实际,有针对性地组织教学资源和设计教学活动,并动态优化教学进程,保证教学质量。借助大数据、手机APP等智能手段对教学效果进行全方位复合评价,从而精准分析、改进教学方案。通过全维度精准培训,做到因材施教、人尽其才,为培养全方位的医学人才提供有力保障。

住院医师规范化培训师资队伍能力提升路径探讨

住院医师规范化培训(简称“住培”)指导医师的综合能力和素质是培养优秀住院医师的重要保障,也是影响住培质量的关键要素。随着我国住培管理制度的不断完善,住培师资队伍能力提升最主要的途径已不仅限于师资培训,骨干师资培育计划也逐渐成为高效提升住培师资能力的创新途径。骨干师资培育计划将住培师资培养目标进行了更加细致的划分,指导医师以自身教学业绩及教学能力水平等为基础,通过开展一系列的教学活动逐步提高综合教学能力。教学管理部门组织专家通过遴选体系、培训体系、考核体系对骨干师资培育对象进行严格的三级培育体系管理,严把入口、过程、出口三个关键环节,强调过程管理和目标考核,并引入住培督导反馈机制,同时配套资助及激励政策。骨干师资培育计划的开展探索了住培师资队伍建设的新途径,对逐步分层次提升住培师资能力提供新的思路。

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。

“清单式培训、积分制管理”模式在骨科住院医师规范化培训中的探索

目的探讨“清单式培训、积分制管理”模式在骨科住院医师规范化培训中的应用的效果。方法参照《住院医师规范化培训基地认定标准》和《住院医师规范化培训内容与标准》的骨科培训要求,组织骨科带教老师制定《住院医师规培骨科常见病、多发病清单》和《住院医师规培骨科核心手术操作技术清单》,选取非骨科专业住院医师,依据上述清单进行骨科培训学习和积分统计并进行出科考核(观察组);采用传统培训方式的住院医师为对照组。最后对两组教学效果包括理论及操作能力考核、教学满意度问卷进行比较。结果观察组理论考核成绩平均为(87.3±5.4)分,操作能力考核成绩平均为(78.7±5.3)分;对照组理论成绩平均为(84.5±6.7)分,操作能力成绩平均为(73.8±5.7)分;两组操作能力成绩差异有统计学意义。教学满意度方面,观察组优于对照组。观察组学生自评结果显示诊断与治疗能力提高得分为(7.9±0.7)分,操作能力提高为(7.7±0.7)分,学习兴趣为(8.0±0.6)分,综合评价得分为(8.1±0.7)分。结论“清单式培训、积分制管理”模式对提高骨科住院医师掌握骨科常见病和基本手术操作能力起到一定作用。

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。

Gibbs反思循环模式结合SimMom模拟教学在妇产科住院医师助产培训中的应用

目的:评价Gibbs反思循环模式结合SimMom模拟教学在妇产科住院医师助产培训中的效果。方法:采用随机数字法,将2020年1月至2021年1月参加妇产科住院医师规范化培训的27人住院医师分成对照组13人,试验组14人。对照组采用SimMom模拟教学方法,试验组采用Gibbs反思循环模式结合SimMom模拟教学方法。培训后对住院医师进行测评,并对两种教学方法的教学效果进行比较。结果:试验组住院医师培训后的两次考核成绩均显著高于对照组(P<0.05),住院医师对Gibbs反思循环模式联合教学方法的总体满意度高于对SimMom模拟教学方法的总体满意度(P<0.05)。结论:Gibbs反思循环模式能够有效提升住院医师在模拟培训学习中的主观能动性,提高住院医师综合能力的同时,也得到住院医师的认可。

强化培训及模拟测试方法在住院医师规范化培训中的应用

目的研究考前强化培训及模拟测试方法在住院医师规范化培训(以下简称“住培”)过程中的应用效果,提高住培医师的培训质量与考核成绩。方法选取广州医科大学附属第一医院2020年11月及2021年12月参加水平测试的内科住培医师作为研究对象,于2021年起在“三大考”前进行强化培训,特别是对末位15%的学员进行个别辅导,并使用模拟考试(包括执业医师模拟考试及水平测试模拟考试)的方法以提高住培学员的最终考试成绩,随后比较2020年、2021年内科住培医师的业务水平测试(简称水平测试)考核结果及执业医师考试结果,分析强化培训与模拟考试的培训效果。结果通过考前强化培训,2021年的水平测试成绩较2020年有进步。2021年住培医师水平测试平均全国百分位为(73.90±23.29)%,高于2020年度的(55.23±28.52)%,差异有统计学意义(P<0.05);2021年住培医师水平测试平均全省百分位为(64.44±26.85)%,高于2020年度的(40.72±28.69)%,差异有统计学意义(P<0.001)。2020年度广州医科大学附属第一医院内科执业医师考试参加考试人数为20名,通过19名,通过率为95.00%;2021年度广州医科大学附属第一医院内科执业医师考试参加考试人数为24名,通过23名,通过率为95.83%。2020、2021年度的执业医师考试通过率比较,差异无统计学意义(P>0.05),连续2年均保持高通过率。2021年,第3、4、5次水平模拟考试成绩均高于第1、2次,差异有统计学意义(P<0.01)。结论通过考前多方面强化培训,及时发现问题并反馈住培医师模拟考试结果,根据模拟考试成绩因材施教,可显著提高整体的水平测试考核成绩;通过加强理论授课及过程管理,可以达到培养优秀临床医师、提高住培质量的目的。