远程教育联合线下辅导在偏远地区住院医师临床胜任力培养中的应用  

Application of distance education combined with offline coaching in clinical competency training of residents in remote areas

作　　者：刘环 陈法余 朱晓丹 朱世飞 王静华 LIU Huan;CHEN Fayu;ZHU Xiaodan(Department of General Practice,Affiliated Hospital of Hang-zhou Normal University,Hangzhou 310015,China)

机构地区：[1]杭州师范大学附属医院全科医学科,浙江杭州310015

出　　处：《全科医学临床与教育》2023年第9期818-821,共4页Clinical Education of General Practice

基　　金：浙江省卫生健康适宜技术培育与推广项目(2021ZH004);杭州市科技发展计划项目(20201203B223);杭州市生物医药和健康产业发展扶持科技专项(2021WJCY136);杭州市生物医药和健康产业发展扶持科技专项(2021WJCY114)。

摘　　要：目的探索远程医学教育联合线下辅导在偏远地区住院医师临床胜任力培养中的应用效果。方法选取偏远地区县医院住院医师和助理医师共46名为研究学员,用随机数字表法分为试验组(n=23)和对照组(n=23)。对照组采用传统的临床带教方法,试验组采用慕课和三甲医院住院医师规范化培训系列讲座及“三基”培训远程继续教育,线下辅导采用小组讨论、教学查房和三级查房。培训结束时采用迷你临床演练评估(Mini-CEX)对住院医师和助理医师的临床胜任力进行评估。问卷调查了解两组师生对相关教学方式的满意度评价。结果Min-CEX结果显示试验组住院医师在医疗面谈、体格检查、人文关怀、临床判断、组织效能、整体评价6个方面的评分均高于对照组住院医师,差异均有统计学意义(t分别=9.15、6.40、12.46、7.90、6.27、9.74,P均<0.05);试验组助理医师在健康咨询方面评分高于对照组助理医师,差异均有统计学意义(t=4.50,P<0.05)。试验组教师及学员对实施远程教育联合线下辅导的模式和Mini-CEX测评方法的满意度较对照组高(Z分别=3.22、2.44,P均<0.05)。结论远程医学教育联合线下辅导在提高偏远地区住院医师临床胜任能力取得了较好效果,满意度高。Objective To explore the effect of distance medical education combined with offline coaching in residency clinical competence training in hospitals in remote areas.Methods A total of 46 residents and assistant physicians from the hospital in remote area were randomly divided into experimental group(n=23)and control group(n=23).The con⁃trol group received traditional clinical teaching.While the experimental group adopted MOOC training,a series of lec⁃tures on standardized training for residents in tertiary hospitals,and"three basics"training for distance continuing educa⁃tion.Offline coaching included group discussion,teaching rounds and three-level rounds.The clinical competency of two groups were evaluated by the Mini-CEX scale.The questionnaire survey showed the satisfaction of the two groups of teachers and students with the relevant teaching methods.Results The Mini-CEX evaluation showed that the scores of six indicators,including medical interview,physical examination,humanistic care,clinical judgment,organizational effec⁃tiveness,overall evaluation of residents in experimental group were higher than the residents in the control group,the differences were statistically significant(t=9.15,6.40,12.46,7.90,6.27,9.74,P<0.05).Compared with the assistant phy⁃sicians in control group,the score of health consulta⁃tion of the assistant physicians in the experimental group were improved,the difference was statistically significant(t=4.50,P<0.05).Teachers and students in the experimental group were more satisfied with the implementation of distance education combined with Mini-CEX(Z=3.22,2.44,P<0.05).Conclu⁃sion Distance education combined with offline coaching have achieved good effects in improving clinical competency of residents in remote areas,with better satisfaction and worth popularizing.

关 键 词：远程医学教育 迷你临床演练评估 住院医师 临床胜任能力 偏远地区 

分 类 号：C975[经济管理—劳动经济] R-4[医药卫生]