朋辈联合CBL导入情境模拟教学在胸心外科住院医师规范化培训中的应用  

Application of peer combined with CBL into situational simulation teaching in standardized training of thoracic surgery residents

作　　者：王高祥 吴明胜 徐广文 吴汉然 孙效辉 柳常青 解明然 WANG Gaoxiang;WU Mingsheng;XU Guangwen;WU Hanran;SUN Xiaohui;LIU Changqing;XIE Mingran(Department of Thoracic Surgery,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)胸外科,安徽合肥230001

出　　处：《中华全科医学》2024年第2期308-311,共4页Chinese Journal of General Practice

基　　金：国家自然科学基金项目(81973643);安徽省重点研究与开发项目(202004j07020017);安徽省高等学校教学研究项目(2020xjyxm089)。

摘　　要：目的探讨胸心外科住院医师规范化培训(简称住培)教学中使用朋辈联合案例教学法(CBL)导入情境模拟教学的效果及可行性。方法选取2021年1月—2022年4月在中国科学技术大学附属第一医院胸外科参加住培的60位住院医师作为研究对象,按照随机数字表法随机分为传统教学法组(A组)和朋辈联合基于CBL导入情境模拟教学组(B组),每组30人。全部教学结束时行迷你临床演练评估(Mini-CEX)和操作技能直接观察评估(DOPS)。培训结束时需要进行理论与技能考核及对教学的满意度调查。结果2组住培医师在年龄、性别、最高学历、专业、参加规培时间方面差异无统计学意义(P>0.05)。B组出科理论成绩和技能成绩均明显高于A组,差异有统计学意义(t=4.977,P<0.001;t=3.607,P=0.001)。B组Mini-CEX评价等级中优秀的占比高于A组,差异有统计学意义(P<0.05)。B组Mini-CEX分数高于A组,差异有统计学意义(t=2.670,P=0.010)。2组在DOPS评价等级及分数方面差异无统计学意义(Z=-0.869,P=0.385;t=0.405,P=0.687)。B组满意度等级中比较满意的占比高于A组,差异有统计学意义(P<0.05)。B组满意度评分高于A组,差异有统计学意义(t=5.007,P<0.001)。结论朋辈联合CBL导入情景模拟教学模式在胸心外科教学方面能够很好地营造良好的学习氛围,提高住培医师自主学习和临床思维能力,具有一定的推广意义。Objective The aimed explore the effectiveness and feasibility of introducing case-based learning(CBL)for situational simulation teaching in the standardized training of thoracic and cardiac surgery residents.Methods Sixty residents who underwent residential training in the Department of Thoracic Surgery at the First Affiliated Hospital of University of Science and Technology of China,from January 2021 to April 2022,were selected as participants.They were randomly divided into two groups:the group A,which received traditional teaching method group,and the group B,which received CBL-based situational simulation teaching group,according to the admission order.The teaching methods included mini-clinical evaluation exercise(mini-CEX),direct observation,and direct observation of procedural skill(DOPS).At the end of the training,theory and skill assessment,as well as teaching satisfaction survey,were conducted.Results There were no significant differences between the two groups in terms of age,sex,highest education,major,and time of participation in training(P>0.05).The theoretical and skill scores of the group B were significantly higher than those of the group A(t=4.977,P<0.001;t=3.607,P=0.001).The proportion of excellent Mini-CEX rating in the group B was higher than that in the group A(P<0.05).Additionally,the Mini-CEX score in the group B was higher than that in the group A(t=2.670,P=0.010).There were no significant difference in DOPS rating and scores between the two groups(Z=-0.869,P=0.385;t=0.405,P=0.687).The satisfaction level of the group B was significantly higher than that of the group A(P<0.05).Similarly,the satisfaction score of the group B was significantly higher than that of the group A(t=5.007,P<0.001).Conclusion The implementation of peer and CBL-based situational simulation teaching mode has the potential to creat a conductive learning atmosphere,improve the independent learning and clinical thinking skills of resident physicians,and hold significant promise for advancement.

关 键 词：朋辈教学 案例学习 住院医师规范化培训 临床基础能力考核 胸外科 

分 类 号：R192[医药卫生—卫生事业管理] R655[医药卫生—公共卫生与预防医学]