“山海”提升工程背景下县域医共体超声实践调查及PBL超声培训模式的探索

“山海”提升工程背景下县域医共体超声实践调查及PBL超声培训模式的探索

Under the background of "Mountain and Sea" promotion project, the investigation of county doctors'common ultrasound practice and the preliminary exploration of PBL ultrasonic training mode

doi: 10.16766/j.cnki.issn.1674-4152.002656

通讯作者:
王静, E-mail: wangjing@hmc.edu.cn

王嶒; 王静; 郑逸; 沈浩能; 陈琦

doi:10.16766/j.cnki.issn.1674-4152.002656

王嶒^{1, 2},
王静^{1, 2, ,},
郑逸³,
沈浩能¹,
陈琦¹

1.
浙江省人民医院(杭州医学院附属人民医院)心脏中心超声医学科, 浙江杭州 310014
2.
浙江省人民医院(杭州医学院附属人民医院)心脏中心护理部
3.
仙居县人民医院(浙江省人民医院浙东南院区)超声医学科, 浙江台州 317300

基金项目:

浙江省公益技术应用研究项目 LGF19H160026

浙江省卫生健康科技计划项目 2021KY062

浙江省卫生健康科技计划项目 2022KY 565

详细信息

中图分类号: R445.1 R197.3
计量
- 文章访问数: 161
- HTML全文浏览量: 59
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2022-01-05
- 网络出版日期: 2022-11-29

注：不同学科比较，χ²=28.546，P=0.018。

WANG Ceng^{1, 2},
WANG Jing^{1, 2
, ,},
ZHENG Yi³,
SHEN Hao-neng¹,
CHEN Qi¹

1.
Cardiovascular Center, Department of Ultrasound Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang 310014, China

摘要

摘要: 目的通过“山海”提升工程省级医院与县级医院的合作帮扶模式，调查县域医共体的超声实践能力，探索超声基于问题式学习培训模式的成效。方法下沉专家于2021年4—10月在仙居县人民医院进行帮扶，针对127名超声医学专科医生采用基于问题式学习(PBL)，以问题为基础，基层医院超声医生为主体，小组讨论为形式，下沉专家为导向的教学方法，将心脏超声作为重点培训内容，分析专家在仙居帮扶期间与专家结束后的相关数据，分别与2020、2021年同期心脏超声检查数据进行比较。结果基层临床医生对超声解决实际工作认可度较高，有94.49%(120/127)的临床医生认为超声可以基本解决临床问题; 不同学历的基层医生对科研的兴趣也不同; 在基于问题式学习的培训模式下，专家帮扶期间心脏超声检查例数、复杂心脏病的诊断例数较2020年同期增多，检查总例数增长率为7.40%，复杂阳性病例增长率为162.86%;专家帮扶结束后(2021年11月—2022年2月)心脏超声检查例数、复杂心脏病的诊断例数较2020—2021年同期增多，检查总例数增长率为10.63%，复杂阳性病例增长率为10.18%。结论医疗卫生“山海”提升工程是一项将帮扶工作落到实处的惠民工程，充分发挥省级医院优势学科，不断提高基层医生的医、教、研水平，也使基层百姓能获得省级医院“同质化”的医疗资源。
- “山海”提升工程 /
- 基于问题式学习 /
- 心脏超声
Abstract: Objective To investigate the ultrasound-practice ability of county doctors and explore the effectiveness of ultrasonic problem-based learning-training mode through the "Mountain and Sea" project, which improved the cooperative assistance mode between provincial hospitals and county-level hospitals. Methods Experts were assisted in Xianju County People's Hospital from April to October 2021. Problem-based learning (PBL) was adopted for ultrasound medical specialists. The teaching method was problem-based, with 127 ultrasound doctors in basic hospitals as the main body, in the form of group discussion and the expert as the guidance. Taking cardiac ultrasound as a key training content, the relevant data of experts during and after Xianju assistance were analysed and compared with the cardiac ultrasound data of the same period in 2020 and 2021. Results Grassroots clinicians had a high recognition of ultrasound to solve the practical work. About 94.49% (120/127) of clinicians believed that ultrasound can basically solve clinical problems. Doctors had different interests in scientific research to different degrees. In the training mode based on PBL, during the period of expert assistance, the number of cases of cardiac ultrasound examination and the diagnosis of complex heart disease increased compared with the same period in 2020. The growth rate of the total cases was 7.40%, and the growth rate of complex positive cases was 162.86%. After the end of expert assistance (November 2021 to February 2022), the number of cases of cardiac ultrasound examination and the diagnosis of complex heart disease increased compared with the same period of 2020-2021. The growth rate of the total number of cases examined was 10.63%, and that of complex positive cases was 10.18%. Conclusion The medical and health "Mountain and Sea" promotion project is a project to help the people and put the work into practice. It gives full play to the superior disciplines of provincial hospitals, thereby constantly improving the medical, teaching, and research level of grassroot doctors and also enabling grassroot people to avail of the "homogenised" medical resources of provincial hospitals.
- "Mountain and Sea" promotion project /
- Problem-based learning /
- Cardiac ultrasound

HTML全文

图 1 临床医生对超声解决问题的满意评价

Figure 1. Evaluation of clinician satisfaction with ultrasound problem solving

下载: 全尺寸图片幻灯片

表 1 不同学科对超声亚专业的感兴趣情况(人)

Table 1. Interest in the ultrasound subspecialty in different disciplines

下载: 导出CSV

表 2 学历、科研经验、科研兴趣相关性的分析(r值)

Table 2. Analysis of the correlation between educational background, research experience and research interest (r values)

项目	学历	科研经验	科研兴趣
学历	1
科研经验	-0.182^a	1
科研兴趣	-0.158	0.308^b	1
注：^aP＜0.05，^bP＜0.01。

下载: 导出CSV

表 3 A组与B组阳性检出例数的比较(例)

Table 3. Comparison of the number of positive cases between group A and group B (cases)

组别	复杂阳性例数	普通阳性例数	合计
A组	184	174	358
B组	70	247	317
注：2组比较，χ²=61.560, P＜0.001。

下载: 导出CSV

表 4 A组与B组各类复杂心脏病检出例数比较(例)

Table 4. Comparison of the detected cases of complex heart disease between group A and group B (cases)

组别	先天性心脏病	心脏瓣膜病	心肌病	大血管疾病	合计
A组	67	62	37	18	184
B组	14	18	25	13	70
注：2组比较，χ²=13.578, P=0.004。

下载: 导出CSV

表 5 C组与D组阳性检出例数比较(例)

Table 5. Comparison of positive detection cases between group C and group D

组别	复杂阳性例数	普通阳性例数	合计
C组	184	66	250
D组	167	167	334
注：2组比较，χ²=33.209, P＜0.001。

下载: 导出CSV

表 6 C组与D组各类复杂心脏病检出例数比较(例)

Table 6. Comparison of detected cases of complex heart disease between group C and group D (cases)

组别	先天性心脏病	心脏瓣膜病	心肌病	大血管疾病	合计
C组	30	85	33	36	184
D组	5	109	32	21	167
注：2组比较，χ²=24.022, P＜0.001。

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