TSP结合情境模拟对住院医师规范化培训指导医师医患沟通教学能力培训的效果研究  

Effectiveness of teacher standardized patients(TSP)combined with scenario simulation in faculty training of doctor-patient communication teaching abilities for standardized residency training

作　　者：李辉雁[1] 黄应雄[2] 顾宏林 戴国琳 张昆松[4] 王少鑫[5] 匡铭[1] 叶子[2] Li Huiyan;Huang Yingxiong;Gu Honglin;Dai Guolin;Zhang Kunsong;Wang Shaoxin;Kuang Ming;Ye Zi(Department of Education,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,Guangdong,China;Emergency Department,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,Guangdong,China;Department of Spine Surgery,Guangdong Provincial People's Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou 510080,Guangdong,China;Department of Pancreatobilliary Surgery,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,Guangdong,China;Medical Training Department,Advanced Continuing Education Center of Sun Yat-sen University,Guangzhou 510080,Guangdong,China)

机构地区：[1]中山大学附属第一医院教育处,广东广州510080 [2]中山大学附属第一医院急诊科,广东广州510080 [3]南方医科大学附属广东省人民医院(广东省医学科学院)脊柱外科,广东广州510080 [4]中山大学附属第一医院胆胰外科,广东广州510080 [5]中山大学继续教育学院医学教育培训中心,广东广州510080

出　　处：《中国毕业后医学教育》2025年第2期127-132,共6页Chinese Journal of Graduate Medical Education

基　　金：2023年度中山大学教学质量与教学改革工程类项目(80000-12220011);2023年广东省度教育科学规划课题(德育专项)(2023JKDY001);2022年中山大学附属第一医院毕业后医学教育教学改革课题(B202212);2021年广东省教育厅高等教育教学改革项目(粤教高函[2021]29号)。

摘　　要：目的探讨教师标准化病人(teacher standardized patients,TSP)结合情境模拟教学工作坊对住院医师规范化培训(简称住培)指导医师医患沟通教学能力的师资培训应用效果。方法选取2020年11月至2023年3月在广东省4家医院参加广东省住培普通师资培训班的288名指导医师作为研究对象。采用对照实验研究,观察组为93人,实施TSP结合情境模拟教学的工作坊模式,对照组为195人,实施传统理论授课模式。采用问卷自评的方式评估两组的培训效果,并使用问卷调查了解培训前后指导医师对医患沟通教学培训的需求与反馈意见。结果76.3%的指导医师此前未接受过医患沟通教学能力培训,培训后观察组指导医师对医患沟通教学能力的掌握认知程度较对照组明显增加[5(4,5)比4(3,5),Z=-4.565,P<0.001],且观察组指导医师在培训后对医患沟通教学能力掌握达到完全理解的认知层次比例较对照组明显增加(54.8%比24.6%,χ^(2)=27.649,P<0.001),观察组中94.6%的指导医师愿意在今后的住培医患沟通教学中尝试使用TSP结合情境模拟教学的工作坊模式。指导医师评价课程培训模式和效果的10个满意度指标中,观察组8个指标得分高于对照组,差异具有统计学意义(P<0.05)。结论TSP结合情境模拟教学的工作坊模式有助于提高指导医师对医患沟通教学的认知层次,短期培训效果满意,可进一步在住培师资培训中推广应用。Objective To explore the application effect of teacher standardized patients(TSP)combined with scenario simulation teaching workshops in the faculty training for standardized residency training(hereinafter referred to as standardized training)in teaching the communication skills between doctors and patients.Methods A total of 288mentor physicians participating in the general faculty training program for standardized training in Guangdong Province from November 2020 to March 2023 in four hospitals in Guangdong Province were selected as the research subjects.A controlled experimental study was conducted,with 93 individuals in the experimental group receiving TSP combined with scenario simulation teaching workshop mode,and 195 individuals in the control group receiving the traditional theoretical teaching mode.A self-evaluation questionnaire was used to assess the training effects of both groups,and a questionnaire survey was conducted to understand the faculty's needs and feedback on the training in doctorpatient communication teaching before and after the training.Results 76.3% of the mentor physicians had not previously received training in doctor-patient communication teaching skills.In the experimental group,the degree of understanding the teaching skills of doctor-patient communication after the training was significantly higher than that in the control group[5(4,5)vs 4(3,5),Z=-4.565,P<0.001].The proportion of mentor physicians in the experimental group who fully understood the teaching skills of doctor-patient communication after the training was significantly higher than that in the control group(54.8%vs 24.6%,χ^(2)=27.649,P<0.001).94.6% of the mentor physicians in the experimental group were willing to try TSP combined with scenario simulation teaching in future doctor-patient communication teaching in standardized training.Among the 10 satisfaction indicators evaluating the training mode and effect,8 indicators scored higher in the experimental group than in the control group,with statistically significan

关 键 词：教师标准化病人 情境模拟教学 医患沟通 住院医师规范化培训 指导医师培训 

分 类 号：G451.2[文化科学—教育学] R4[文化科学—教育技术学]