临床路径在住院医师规范化培训呼吸内科轮转教学中的应用与评析  

Application of clinical pathway in the teaching of respiratory medicine for residency standard training program

作　　者：张景熙[1] 石荟[1] 夏阳[1] 聂小蒙[1] 李强[1] 白冲[1] 

机构地区：[1]第二军医大学附属长海医院呼吸与危重症医学科,上海,200433

出　　处：《中华医学教育探索杂志》2016年第6期580-584,共5页Chinese Journal of Medical Education Research

基　　金：中华医学会医学教育分会医学教育研究立项课题基金资助项目（2012-QK-17）;第二军医大学附属长海医院教学改革研究基金（CHJG2013002）

摘　　要：目的：探讨临床路径在住院医师规范化培训呼吸内科轮转教学中的应用与意义。方法选择2014年3至11月在呼吸内科轮转的47名规范化培训住院医师分为2组，其中路径组（n＝24）教学中引入临床路径管理疾病模式，对照组（n＝23）采用传统教学。培训4周后，对2组住院医师进行基本理论及病例分析考核；培训期间每周评估2组独立正确开具化疗医嘱的能力；培训后对2组进行教学满意度调查，并对路径组进行临床路径教学有效性调查。应用GraphPad Prism 5.0，对组间数据比较行t检验。结果路径组住院医师基本理论及病例分析成绩均高于对照组，差异具有统计学意义（P〈0.05）。路径组第1、2、3和4周独立开具化疗医嘱的考核平均得分依次为（70.75±2.79）、（81.43±1.91）、（85.23±1.39）和（90.62±2.34）分，对照组每周平均得分为（69.65±2.06）、（77.11±2.21）、（80.3±1.96）和（87.78±2.21）分；路径组每周平均得分均高于对照组，且第2周起2组间差异具有统计学意义（P〈0.05）。路径组对临床路径教学的整体满意度为95.84%（23/24），教学满意度高于对照组（91.29%，21/23）。路径组医师认为相关教学有效提高了自身各项知识水平、经验、能力。结论临床路径教学有利于规范带教教师教学行为，培养住院医师规范化、标准化的诊疗行为，提高住院医师临床工作能力，促进教学相长。Objective To explore the effect and significance of clinical pathway guided teaching in the residency standard training program of respiratory medicine. Methods Total 47 resident physicians were selected and divided into clinical pathway group and control group from March 2014 to November 2014. The pathway group （n=24） was introduced into the teaching guided by clinical pathway management. The control group （n=23） was taught by traditional teaching method. All physicians were tested for the basic theory and the ability of case analysis after 4 weeks training. The ability of chemotherapy strategy ordered by residents independently and correctly was assessed each week during training. A satisfaction questionnaire survey was conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. GraphPad Prism 5.0 was used and T test was done for comparison of data between groups. Results The medical records about basic theory and case analysis in the pathway group was higher than those in the control group with significant statistical difference （P〈0.05）. The records of resident physicians who could issue orders for chemotherapy independently and correctly were （70.75±2.79）, （81.43±1.91）, （85.23±1.3）, （90.62±2.34） in the pathway group and （69.65±2.06）, （77.11±2.21）, （80.3±1.96）, （87.78±2.21） in the control group at each week time point. There was statistical increase of the records in the pathway group than in the control group since the second week time point （P〈0.05） The overall satisfaction of the pathway group was 95.84%（23/24）, and the teaching satisfaction was higher than that of the control group（91.29%, 21/23）. Pathway group doctors believe that the relevant teaching effectively improve the level of their knowledge , experience and ability. Conclusions The teaching method guided by clinical pathway is help-ful to standardize the teaching behavior, develop the standardized medical behavior of resident physicians, imp

关 键 词：呼吸内科 临床路径 临床教学 住院医师 规范化培训 

分 类 号：R56[医药卫生—呼吸系统]