以问题导入为基础的临床思维在全科医生转岗培训消化内科教学中的应用效果  

Application of problem-oriented clinical thinking teaching in gastroentrology rotation for general practice in-service training

作　　者：张巍巍[1] 沈磊[2] 许琳[1] 耿长新[1] 解祥军[1] 赵丽萍[1] 孙昕[1] 李培杰[3] Zhang Weiwei;Shen Lei;Xu Lin;Geng Changxin;Xie Xiangjun;Zhao Liping;Sun Xin;Li Peijie(Department of Gastroenterology,Qingdao Municipal Hospital,Qingdao 266071,China;Department of Gastroenterology,Zibo Central Hospital,Zibo 255036,China;Division of Education,Qingdao Municipal Hospital,Qingdao 266071,China)

机构地区：[1]青岛市市立医院消化科,266071 [2]淄博市中心医院消化内科,255036 [3]青岛市市立医院教育科,266071

出　　处：《中华全科医师杂志》2021年第7期786-789,共4页Chinese Journal of General Practitioners

摘　　要：为探讨以问题导入为基础的临床思维教学方式在消化内科轮转的转岗全科医生培养中的应用效果,以2017年7月至2019年7月在青岛市市立医院消化内科轮转的60名转岗全科医生为研究对象,随机分为试验组和对照组(每组各30名),两组分别采用问题导入和传统授课的教学方式对消化科两种常见疾病(上消化道出血和急性胰腺炎)进行临床培训,应用形成性评价及问卷调查方式比较两种教学方式的教学效果。结果显示,试验组学员的临床心理素质、临床思维能力、医患沟通能力以及基于实践的学习和改进能力等测评指标优良率均较对照组明显提高,差异有统计学意义(χ^(²)=7.38,P=0.03;χ^(²)=12.96,P<0.01;χ^(²)=23.33 P<0.01;χ^(²)=16.14,P<0.01);试验组学员对教学满意认同程度显著高于对照组(χ^(²)=12.86,P<0.01),临床思维分析能力、学习主动创新性和自信心也高于对照组(χ^(²)=8.26,P=0.02;χ^(²)=19.48,P<0.01;χ^(²)=21.46,P<0.01)。提示以问题导入为基础的临床思维教学方式在消化内科轮转的转岗全科医生培养中取得了较好的效果,更有利于提高其临床综合能力。Sixty general practitioners of in-service training undertaking rotation in gastroenterology department of Qingdao Municipal Hospital from July 2017 to July 2019 were randomized assigned in trial group(n=30)and control group(n=30).The problem-oriented mode was applied in trial group and conventional mode was applied in control group for teaching of two typical digestive diseases(upper gastrointestinal bleeding and acute pancreatitis).The formative evaluation and questionnaire survey were used to compare the teaching effects and the results of evaluation were compared withχ2 test by SPSS 17.0 between two groups.The excellent and good rates of evaluation for the clinical psychological quality,clinical reasoning ability,doctor-patient communication ability and practice-based learning and improvement ability in trial group were significantly higher than those in the control group(χ^(²)=7.38,P=0.03;χ^(²)=12.96,P<0.01;χ^(²)=23.33,P<0.01;χ^(²)=16.14,P<0.01).Questionnaire survey showed more satisfaction towards teaching method in trial group was higher than that in control group(χ^(²)=12.86,P<0.01);and the clinical reasoning ability,learning initiative and self-confidence in trial group were improved more markedly than those in control group(χ^(²)=8.26,P=0.02;χ^(²)=19.48,P<0.01;χ^(²)=21.46,P<0.01).The problem-oriented clinical thinking teaching model demonstrates good effects on clinical comprehensive ability for general practitioners of in-service training during gastroenterology rotation,which is worth further promotion.

关 键 词：在职培训 医院 教学 全科医生 

分 类 号：R-4[医药卫生] C975[经济管理—劳动经济]