Application of multi-disciplinary collaborative and situational simulation teaching in standardized training for general practitioners
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摘要:
目的 探索多学科协作联合情境模拟教学在全科医师规范化培训教学中的应用效果,以改善临床教学质量。 方法 将情境模拟教学引入全科医师规培教学,将上海交通大学医学院附属瑞金医院临床医学院2022学年在培的全科住院医师共45人采用简单随机分组分成实验组和对照组,实验组学员(23名)接受常规教学培训结合情境模拟教学,对照组学员(22名)接受常规教学培训,比较2组学员的年终考核成绩,观察情境模拟教学在全科医师规培中的教学效果。 结果 理论考试中实验组成绩平均值(80.22±4.10)略高于对照组学员(79.73±3.28),但差异无统计学意义(P>0.05);实验组OSCE考试中,病史采集成绩(81.22±4.09)与医患沟通成绩(81.39±9.06)则分别明显优于常规教学组的病史采集成绩(78.45±3.78)与医患沟通成绩(72.14±7.27),2组间差异均有统计学意义(P<0.05)。实验组对教学满意度优于对照组, 差异有统计学意义(P<0.05)。同时实验组学习积极性、参与性明显提高。 结论 在全科医师规培教学中,采用多学科协作联合情境模拟教学方法,能有效提升接受规培学员的学习主动性,有助于提高医患沟通能力及临床应变能力,且学员对教学的满意度更高,值得在全科规培教学中进行推广。 Abstract:Objective To explore the application effect of multi-disciplinary collaborative and situational simulation teaching in standardized training for general practitioners, so as to improve the quality of clinical teaching. Methods Situational simulative teaching was introduced into the training of general practitioners. A total of 45 general practitioners in the Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in 2022 were divided into experimental group and control group by simple random grouping. The experimental group (23 students) received routine teaching training combined with situational simulative teaching, while the control group (22 students) received routine teaching training. The year-end assessment results of the two groups of students were compared, and the teaching effect of situational simulative teaching in the training of general practitioners was observed. Results The average score of the experimental group (80.22±4.10) in the theoretical exam was slightly higher than that of the control group (79.73 ± 3.28), but the difference was not statistically significant (P > 0.05). In the experimental group' s OSCE exam, the scores of medical history collection (81.22±4.09) and doctor-patient communication (81.39±9.06) were significantly better than those of the control group (78.45 ± 3.78 and 72.14±7.27), and the differences were statistically significant (P < 0.05). The experimental group showed better satisfaction with teaching than the control group, and the difference was statistically significant (P < 0.05). At the same time, the experimental group' s learning enthusiasm and participation had significantly improved. Conclusion In the process of general practitioner training education, the use of multi-disciplinary collaborative and situational simulation teaching can effectively enhance the learning initiative of students, help improve doctor-patient communication skills and clinical adaptability, and students have higher satisfaction with teaching. It is worthwhile to promote in the teaching of general practice. -
表 1 2组学员基本资料比较
Table 1. Comparison of Basic Information between Two Groups of Students
组别 人数 性别(男/女,人数) 年龄(x±s,岁) 轮转时间(x±s,月) 实验组 23 8/15 24.87±1.98 21.48±9.89 对照组 22 5/17 25.32±1.76 22.00±9.80 统计量 0.796a -0.802b -0.178b P值 0.378 0.427 0.860 注:a为χ2值,b为t值。 表 2 2组学员的年终考核成绩比较(x±s,分)
Table 2. Comparison of assessment scores between two groups of students(x±s, points)
组别 人数 理论成绩 病史采集 病史书写 病例分析 临床操作 医患沟通 实验组 23 80.22±4.10 81.22±4.09 89.78±4.28 83.91±4.01 88.48±3.94 81.39±9.06 对照组 22 79.73±3.28 78.45±3.78 86.00±8.32 81.64±5.31 82.68±6.57 72.14±7.27 t值 0.441 2.352 1.905 1.629 3.569 3.769 P值 0.661 0.023 0.066 0.111 0.001 <0.001 表 3 2组学员对教学满意度比较情况
Table 3. Comparison of satisfaction with teaching effectiveness between two groups of students
组别 人数 学员自我评价 对教师评价 对教学方法评价 实验组 23 8.47±0.49 8.79±0.56 8.41±0.71 对照组 22 7.62±0.91 8.07±0.70 7.80±0.78 t值 3.965 5.904 11.773 P值 <0.001 <0.001 <0.001 表 4 情境模拟教学组学员教学效果反馈情况(n=23)
Table 4. Feedback on teaching effectiveness of students in situational simulation teaching group(n=23)
教学效果反馈 明显提高(人数) 提高(人数) 一般(人数) 没有(人数) 明显提高(%) 学习兴趣、积极性提高 18 5 0 0 78.26 全科医学思维能力的提高 20 2 1 0 86.96 医患沟通能力的提高 21 1 1 0 91.30 理论知识的巩固 19 2 2 0 82.61 临床应变能力的提高 22 1 0 0 95.65 -
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