沉浸式团队情境模拟教学在急诊科临床胜任力培养的探索与实践  

Exploration and practice of immersive team scenario simulation teaching in clinical competence training of emergency medicine

作　　者：黄勇[1] 黄应雄[1] 王科科[1] 李慧[1] 刘江辉[1] Huang Yong;Huang Yingxiong;Wang Keke;Li Hui;Liu Jianghui(Department of Emergency,the First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,Guangdong,China)

机构地区：[1]中山大学附属第一医院急诊科,广东广州510080

出　　处：《中国毕业后医学教育》2024年第7期544-548,共5页Chinese Journal of Graduate Medical Education

基　　金：2022年中山大学校级教学质量与教学改革工程项目(SYSU-2022-299-969);2022年中山一院院级毕业后医学教育教学改革课题(B202220);广东省教育厅临床教学基地本科教级项目(2021JD002);广东省“新医科”教学改革项目(2023-44)。

摘　　要：目的 探索在急诊临床教学过程中开展沉浸式团队情境模拟教学在提高临床胜任力方面的效果。方法 培养对象为轮转中山大学附属第一医院急诊科的28名见习医生和28名第2~3年住院医师,随机配对组建两人抢救小组,在实施情境模拟教学前进行学习需求的问卷调查,指导老师根据问卷结果设定团队情境模拟教学的内容,采用评分表对抢救小组成员的临床能力和人文素养等方面进行评估,培训结束时发放问卷,进行满意度调查。结果 培训前见习医生注重理论知识如何转化为临床应用(27/28,96.4%),而第2~3年住院医师更关注急诊的快速反应能力(27/28,96.4%)和预见临床可能出现的突发状况(26/28,92.9%)。团队模拟教学后,见习医生第二次培训评分较第一次培训高,主要表现在危重病人接诊过程中问诊技巧、临床思维能力方面;第2~3年住院医师经过两次模拟教学培训在处置急症患者时,表现出在急症的快速反应、医患沟通能力,以及人文素养方面能力的提升。培训后见习医生和第2~3年住院医师对团队情境模拟教学均具有良好认可度。结论 沉浸式团队情境模拟教学紧密贴合不同群体的学习需求,提高受试对象的学习主动性、团队合作和人文素养等,提升了临床教学的培训质量,获得了较高的认可度。Objective To explore the effect of immersive team scenario simulation teaching on improving clinical competence in emergency teaching.Methods Twenty-eight intern doctors and 28 second-and thirdyear resident doctors were enrolled and randomly matched to form two-person rescue teams in this study.A questionnaire survey of learning needs was conducted before the implementation of scenario simulation teaching.A trauma simulation-based session was developed according to the interview.The clinical ability and humanistic quality of the rescue teams were evaluated by a rating scale.The teaching effect and satisfaction were evaluated by a questionnaire survey at the end of the training.Results Preliminary results of the interviews showed that intern doctors concerned about how to translate theoretical knowledge into clinical application(27/28,96.4%),while resident doctors in the second to third years paid more attention to the ability to respond quickly to emergency(27/28,96.4%)and to anticipate possible clinical emergencies(26/28,92.9%).After simulated teaching training,the second training scores of the intern doctors were higher than those of the first training,which was mainly manifested in the consultation skills and clinical thinking ability.After two simulated teaching trainings,the second-and third-year residents showed improvement in the ability of quick response,doctor-patient communication and humanistic quality in handling emergency patients.The results of post-training questionnaire showed that both intern doctors and residents in the 2nd to 3rd years had a good recognition of differentiated scenario simulation teaching.Conclusion Immersive team scenario simulation teaching closely fits the learning needs of different groups,is conducive to improving the clinical competence of doctors,and has gained a high degree of recognition.

关 键 词：情境模拟教学 急诊科 胜任力 团队 沉浸式体验 

分 类 号：G40-034[文化科学—教育学原理] R605[文化科学—教育学]