床旁立体教学方法在心血管重症监护专科临床教学中的应用效果  

Application of bedside stereo-teaching method in clinical teaching of cardiac intensive care specialty

作　　者：夏珂[1,2] 李非[1,2] 赵震宇[3] 杨天伦[1,2] XIA Ke;LI Fei;ZHAO Zhenyu;YANG Tianlun(Department of Cardiology,Xiangya Hospital,Central South University,Changsha 410078,China;Department of Internal Medicine,Xiangya Hospital,Central South University,Changsha 410078,China;Institute of Clinical Pharmacology,Xiangya Hospital,Central South University,Changsha 410078,China)

机构地区：[1]中南大学湘雅医院心内科,长沙410078 [2]中南大学湘雅医院内科学教研室,长沙410078 [3]中南大学湘雅医院临床药理研究所,长沙410078

出　　处：《浙江医学教育》2023年第1期37-43,共7页Zhejiang Medical Education

基　　金：中华医学会医学教育分会和中国高等教育学会医学教育专业委员会2020年度医学教育研究重点立项课题:“心音数据库建立及其在心脏听诊教学中的作用”(20A0034);中南大学2020年教学改革课题:“床旁立体教学法在心血管内科临床教学中的应用探讨”(2020JY151);2020中南大学线上金课:“诊断学A:诊断学之心电图、心脏听诊视听教学”(220101Z10)。

摘　　要：目的探讨床旁立体教学方法在心血管重症监护专科临床教学中的应用效果。方法选择在中南大学湘雅医院心血管重症监护专科培训的65名住院医师为研究对象,将其随机分为试验组和对照组。试验组33名住院医师,采用床旁立体教学方法(联合并融会贯通“基于问题学习教学方法、基于案例学习教学方法、Seminar教学方法、临床路径教学方法”);对照组32名住院医师,采用传统教学方法。教学结束后,采用问卷调查和出科考试方式,评估并比较两组住院医师不同教学方法的实施效果。结果首先,试验组中认为自己各方面临床能力(检索文献、结合指南诊疗、结合量表评估疾病严重程度、临床思维、临床诊断、临床治疗、团队合作)有所提高的住院医师占比明显高于对照组住院医师(P<0.05)。其次,试验组中认为其对各种严重心血管重症监护专科突发状况的处理能力(急性心衰、急性冠脉综合征、急性肺栓塞、高血压危象、低血压休克、室上性心律失常)有所提高的住院医师占比明显高于对照组住院医师(P<0.05)。再次,试验组中认为其对心脏重症患者各系统严重合并症的处理能力(合并呼吸系统疾病、消化系统疾病、糖尿病、多器官功能不全、酸碱失衡、营养不良、严重感染)有所提高的住院医师占比明显高于对照组住院医师(P<0.05)。最后,试验组住院医师的出科考试成绩显著高于对照组住院医师(P<0.05)。结论床旁立体教学方法在心血管重症监护专科的临床教学中取得了良好的效果。试验组绝大多数住院医师认为,实施立体教学方法提高了他们的学习兴趣和各种临床能力,提高了他们处理各种严重心血管重症监护专科突发状况、心脏重症患者各系统严重合并症的能力;同时,提高了他们的出科考试成绩。床旁立体教学方法值得在心血管重症监护专科的临床教学中加�Objective To explore the application effect of bedside stereo-teaching method in clinical teaching of cardiovascular intensive care specialty.Methods 65 residents who entered the cardiovascular intensive care specialty,Xiangya Hospital,Central South University,were selected as the research objects and randomly divided into the experimental group and the control group.33 residents in the experimental group adopted Bedside stereo-teaching method(combining and mastering“problem-based learning teaching method,case-based learning teaching method,seminar teaching method and clinical pathway teaching method”);The control group,32 residents,adopted traditional teaching methods.After the study,questionnaire survey and examination before ending study in cardiac intensive care specialty were used to compare and evaluate the effect of different teaching methods between the two groups of residents.Results First of all,the proportion of residents in the experimental group thought that their clinical abilities(literature retrieval,diagnosis and treatment with guidelines,evaluation of disease severity with scales,clinical thinking,clinical diagnosis,clinical treatment and teamwork)had been improved was significantly higher than that of in the control group(P<0.05).Secondly,the proportion of residents in the experimental group thought that their ability to deal with various emergencies in cardiovascular intensive care specialty(acute heart failure,acute coronary syndrome,acute pulmonary embolism,hypertensive crisis,hypotension shock,supraventricular arrhythmia)had been improved was significantly higher than that of in the control group(P<0.05).Thirdly,the proportion of residents in the experimental group thought that their ability to deal with various severe complications of other systems(respiratory diseases,digestive diseases,diabetes,multiple organ dysfunction,acid-base imbalance,malnutrition,severe infection)had been improved was significantly higher than that of in the control group(P<0.05).Finally,the scores of the resi

关 键 词：床旁立体教学方法 心血管重症监护专科 住院医师 临床教学 应用效果 

分 类 号：R-05[医药卫生]