标准化病人联合莱斯特评估法在全科门诊教学中的应用效果

靳明伟; 樊姨君; 郭明; 白杨; 詹学斌; 李季萌

doi:10.16766/j.cnki.issn.1674-4152.003773

标准化病人联合莱斯特评估法在全科门诊教学中的应用效果

doi: 10.16766/j.cnki.issn.1674-4152.003773

郑州市第七人民医院全科医学科，河南郑州 450000

基金项目:

河南省医学研究教育项目 Wjlx2021426

详细信息

通讯作者:
靳明伟，E-mail：dr.jmw@163.com

中图分类号: R192
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- 被引次数: 0
出版历程
- 收稿日期: 2023-09-05
- 网络出版日期: 2024-12-31

Application effect of standardized patient combined with Leicester assessment package evaluation method in general outpatient teaching

Department of General Practice, the Seventh People' s Hospital of Zhengzhou, Zhengzhou, Henan 450000, China

摘要

摘要: 目的探讨标准化病人(SP)联合莱斯特评估法(LAP)在全科门诊教学中的应用价值。方法选取郑州市第七人民医院2021—2022年参加助理全科医师规范化培训(助理全科规培)的30名学员及全科住院医师规范化培训(规培)的20名学员为研究对象，采用随机数字表法分为试验组与对照组，其中助理全科规培学员试验组A组及对照组B组各15名，规培学员试验组C组及对照组D组各10名。每位学员均进行为期3个月的全科门诊教学培训，试验组及对照组分别采用SP联合LAP及传统门诊教学进行培训。比较各组执业助理医师资格考试通过率、结业考核通过率、执业医师通过率及第1次培训与最后1次培训试验组LAP得分。结果培训后，A组执业助理医师资格考试通过率及结业考核通过率均高于B组，C组执业医师通过率高于D组，差异均有统计学意义(P < 0.05)；A组助理全科学员LAP评估量表中病史采集、体格检查、解决问题、患者管理、医患关系、预防保健及病历记录7个项目得分均比第1次培训提高，差异均有统计学意义(P < 0.05)；C组规培学员LAP评估量表中病史采集、解决问题、患者管理、医患关系及预防保健5个项目得分均较培训前提高，差异均有统计学意义(t=3.380、5.786、3.983、4.670、3.207，均P < 0.05)。结论 SP联合LAP评估法教学是有效、可靠的门诊教学方法，值得在全科门诊教学中进一步推广应用。
- 标准化病人 /
- 莱斯特评估法 /
- 全科门诊教学
Abstract: Objective Exploring the application value of standardized patient (SP) combined with Leicester assessment package (LAP) in general outpatient teaching. Methods Thirty students who participated in the general assistant training program at the Seventh People' s Hospital of Zhengzhou from 2021 to 2022, as well as 20 students who participated in residential training, were selected as the research subjects. They were divided into an experimental group and a control group using a random number table method. There were 15 assistant general practice trainees in the experimental group A and control group B, respectively. There were 10 resident trainees in the experimental group C and control group D, respectively. Each student received a 3-month general practice outpatient teaching training. The experimental group and control group received training using SP combined LAP evaluation method and traditional outpatient teaching, respectively. The pass rates of examination of assistant practicing doctors' qualifications, completion assessments, and practicing physicians between the two groups, and LAP scores of the first and last training in the experimental group were compared. Results After the training, the passing rate of examination of assistant practicing doctors' qualifications and completion assessment in Group A were higher than those in Group B, while the passing rate of medical practitioners in Group C was higher than that in Group D, the differences were statistically significant (P < 0.05); The scores of 7 items in the LAP assessment scale for assistant general practitioners in Group A, including medical history collection, physical examination, problem-solving, patient management, doctor-patient relationship, expected care, and medical records, all improved compared to before training, and the differences were statistically significant (P < 0.05); The scores of five items in the LAP assessment scale for group C residential trainees, including medical history collection, problem solving, patient management, doctor-patient relationship, and expected care, all improved compared to before the training, and the differences were statistically significant (t=3.380, 5.786, 3.983, 4.670, 3.207, all P < 0.05). Conclusion The combination of SP and LAP evaluation method is an effective and reliable outpatient teaching method, which is worth further promoting and applying in general outpatient teaching.
- Standardized patients /
- Leicester assessment package /
- General outpatient teaching

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表 1 2组助理全科规培学员基线资料比较

Table 1. Comparison of baseline data between two groups of general practice assistant trainees

组别	例数	性别[人(%)]		年龄(x±s, 岁)
组别	例数	女性	男性	年龄(x±s, 岁)
对照组	15	8(53.3)	7(46.7)	24.00±1.73
试验组	15	10(66.7)	5(33.3)	25.47±1.72
t值				1.014
P值		0.710^a		0.319
注：^a为采用Fisher精确检验。

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表 2 2组规培学员基线资料比较

Table 2. Comparison of baseline data of the two groups of standardized training trainees

组别	例数	性别[人(%)]		年龄(x±s, 岁)
组别	例数	女性	男性	年龄(x±s, 岁)
对照组	10	7(70.0)	3(30.0)	27.20±1.99
试验组	10	4(40.0)	6(60.0)	25.80±1.23
t值				1.894
P值		0.370^a		0.074
注：^a为采用Fisher精确检验。

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表 3 A组助理全科规培学员培训前后LAP得分比较(分)

Table 3. Comparison of LAP scores before and after training in group A general practice assistant trainees

时间	人数	接诊和病史采集(x±s)	体格检查(x±s)	解决问题(x±s)	患者管理(x±s)	医患关系(x±s)	预防保健[M(P₂₅, P₇₅)]	病历记录(x±s)	总分(x±s)
第1次培训	15	13.30±2.31	6.50±0.91	14.73±1.99	13.07±2.56	7.20±1.45	8.0(7.4, 9.2)	6.73±1.03	68.03±7.47
最后1次培训	15	17.50±0.96	8.80±0.77	18.40±0.63	18.10±1.07	9.53±0.64	9.0(8.4, 9.4)	8.00±0.65	88.67±2.63
统计量		6.248^a	6.965^a	6.730^a	7.378^a	5.688^a	-2.807^b	5.551^a	10.324^a
P值		< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	0.005	< 0.001	< 0.001
注：^a为t值，^b为Z值。

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表 4 C组规培学员培训前后LAP得分比较(x±s, 分)

Table 4. Comparison of LAP scores before and after training for group C trainees (x±s, score)

时间	人数	接诊和病史采集	体格检查	解决问题	患者管理	医患关系	预防保健	病历记录	总分
第1次培训	10	14.10±1.68	7.10±2.73	15.10±1.61	14.40±2.60	7.20±0.79	7.30±1.25	7.60±1.35	72.80±5.27
最后1次培训	10	16.65±1.45	8.80±1.23	17.80±1.48	17.60±1.26	9.10±0.99	8.90±0.74	8.50±0.85	87.35±3.27
t值		3.380	2.047	5.786	3.983	4.670	3.207	1.445	12.944
P值		0.008	0.071	< 0.001	0.003	0.001	0.011	0.182	< 0.001

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表 5 A组与B组助理全科规培学员考核通过率比较[人(%)]

Table 5. Comparison of passing rates of general practice assistant trainees between the group A and the group B [person (%)]

组别	人数	助理执业医师考试		助理结业考试
组别	人数	通过	不通过	通过	不通过
A组	15	12(80.0)	3(20.0)	15(100.0)	0
B组	15	4(26.7)	11(73.3)	9(60.0)	6(40.0)
P值		0.009^a		0.017^a
注：^a为采用Fisher精确检验。

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表 6 C组和D组规培学员执业医师通过率比较[人(%)]

Table 6. Comparison of passing rates of medical practitioners between the group C and the group D [people (%)]

组别	人数	通过	不通过
C组	10	9(90.0)	1(10.0)
D组	9	3(33.3)	6(66.7)
P值		0.020^a
注：^a为采用Fisher精确检验。

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