住专一体化模式下普通外科手术分解分类带教的探索及应用  

Exploration and application of decomposing teaching of general surgery under the mode of integration of residency and specialty

作　　者：廉东波 许光中 杜德晓 阿民布和 邓莹婵 王娜 朱斌 张能维 Lian Dongbo;Xu Guangzhong;Du Dexiao;Amin Buhe;Deng Yingchan;Wang Na;Zhu Bin;Zhang Nengwei(Department of General Surgery,Beijing Shijitan Hospital,CMU,Beijing 100038,China;Education Department,Beijing Shijitan Hospital,CMU,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院普通外科,北京100038 [2]首都医科大学附属北京世纪坛医院教育处,北京100038

出　　处：《中国毕业后医学教育》2023年第8期624-628,共5页Chinese Journal of Graduate Medical Education

基　　金：首都医科大学教育教学改革项目(2021JYS034)。

摘　　要：目的探索住专一体化模式下普通外科手术分解分类带教的方法。方法按照住院医师和专培医师培养要求,将普通外科常见手术及重大手术进行分类及分解,使不同层次的培训对象都能在手术中获得独立操作机会。结合Milestone,为住院医师和专培医师制定分阶段递进式的手术技术培养计划。对进入研究的住院医师和专培医师进行基线测试,并在出科时进行考核,与既往常规培养模式进行比较,探索该方案的有效性。结果将普通外科常见手术及重大手术进行分解,分别由住院医师和专培医师进行独立操作,并由指导医师或上级医师完成手术的核心部分。以此为基础,为住院医师和专培医师制定分阶段递进式的手术技术培养计划,并制定手册。住专一体化模式下住院医师基线成绩为(33.08±3.85)分,既往常规培训模式基线成绩为(32.96±3.55)分,二者差异无统计学意义(P>0.05);住专一体化模式下住院医师出科成绩为(41.67±5.19)分,既往常规培训模式出科成绩为(39.14±5.67)分,二者差异具有统计学意义(P<0.05)。住专一体化模式下专培医师基线成绩为(35.13±5.32)分,既往常规培训模式基线成绩为(34.93±6.04)分,二者差异无统计学意义(P>0.05);住专一体化模式下专培医师出科成绩为(45.27±5.20)分,既往常规培训模式出科成绩为(42.14±4.42)分,二者差异具有统计学意义(P<0.05)。结论与既往常规培养模式相比,住专一体化手术培养模式下的普通外科手术分解分类带教能够显著提高培训对象的手术操作能力。Objective To explore the teaching method of general surgery under the mode of residentspecialist integration.Methods According to the training requirements of resident and specialist trainees,operations in general surgery were classified and decomposed,so that students at different levels could obtain corresponding independent operation opportunities during the operation.Combined with Milestone principle,a staged and progressive training plan for surgical techniques was developed for resident and specialist trainees.All resident and specialist trainees who entered the study were tested in baseline and assessed at the rotation test.The results were compared with the previous conventional training mode to explore the effectiveness of the program.Results Common and important operations in general surgery were decomposed.The residents and specialists conducted independent steps,as well as core parts completed by instructors or superior physicians.On this basis,this study developed a staged and progressive surgical technology training plan for residents and specialists,and developed manuals for teachers,residents and specialists.The baseline score of residents was(33.08±3.85)points under the new training mode,and(32.96±3.55)points under the previous conventional training mode without statistically significant difference(P>0.05).The rotation test score of residents was(41.67±5.19)points under the new mode,and(39.14±5.67)points under the previous conventional training mode with statistically significant difference(P<0.05).The baseline score of the specialists was(35.13±5.32)points under the new training mode,and(34.93±6.04)points under the previous conventional training mode without statistically significant difference(P>0.05).The rotation test score of specialists under the new training mode was(45.27±5.20)points,and(42.14±4.42)points under the previous conventional training mode with statistically significant difference(P<0.05).Conclusion Compared with the previous conventional training mode,the decomposing te

关 键 词：普通外科 住专一体化 外科住院医师规范化培训 专科医师规范化培训 手术分解带教 

分 类 号：G40-034[文化科学—教育学原理] R615[文化科学—教育学]